Provider Demographics
NPI:1679898332
Name:RODRIGUEZ, CARLOS F (MD)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:F
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 863407
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32886-3407
Mailing Address - Country:US
Mailing Address - Phone:941-917-2600
Mailing Address - Fax:941-917-7884
Practice Address - Street 1:5350 UNIVERSITY PKWY
Practice Address - Street 2:SUITE 101
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-5812
Practice Address - Country:US
Practice Address - Phone:941-917-4675
Practice Address - Fax:941-917-4688
Is Sole Proprietor?:No
Enumeration Date:2010-04-06
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-7251208D00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL33181OtherBCBS
AR190702001Medicaid
FL016542300Medicaid
AR5I1057242Medicare PIN
FLIL628XMedicare PIN