Enrique Rodriguez, LSA
Specialist/Technologist, Other, Surgical Assistant in Lake Mary, FL. Individual provider (NPI-1).
NPI number1124319165
StatusActive
Last updated in NPPESAug 19, 2014
Details
- NPI
- 1124319165
- Entity type
- Individual (NPI-1)
- Name
- Mr. Enrique Rodriguez
- Credential
- LSA
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Apr 25, 2011
- Last updated
- Aug 19, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 246ZC0007X | Specialist/Technologist, Other, Surgical Assistant | SA0118 | DC | Yes |
| 246ZC0007X | Specialist/Technologist, Other, Surgical Assistant | – | FL | |
| 246ZC0007X | Specialist/Technologist, Other, Surgical Assistant | 238.000374 | IL |
Practice location
765 Creakwater TerraceApt. 205
Lake Mary, FL 32746
Phone 856-203-5655
Mailing address
765 Creakwater TerraceApt. 205
Lake Mary, FL 32746
Phone 856-203-5655
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