| Julio L Rodriguez Md Pa | |
|
4881 Palm Beach Blvd Ste 100 Fort Myers FL 33905-3217 | |
| (239) 693-9191 | |
| (239) 693-7369 |
| Full Name | Julio L Rodriguez Md Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 4881 Palm Beach Blvd Ste 100, Fort Myers, Florida |
| Authorized Official Name and Position | Julio Lazaro Rodriguez (PRESIDENT) |
| Authorized Official Contact | 2396939191 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Julio L Rodriguez Md Pa 4881 Palm Beach Blvd Ste 100 Fort Myers FL 33905-3217 Ph: (239) 693-9191 | Julio L Rodriguez Md Pa 4881 Palm Beach Blvd Ste 100 Fort Myers FL 33905-3217 Ph: (239) 693-9191 |
| NPI Number | 1396045266 |
|---|---|
| Provider Enumeration Date | 10/26/2010 |
| Last Update Date | 10/26/2010 |
| Medicare PECOS PAC ID | 9436347226 |
|---|---|
| Medicare Enrollment ID | O20101221000295 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396045266 | NPI | - | NPPES |
| 052174400 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME59828 (Florida) | Primary |
| Provider Name | Julio Rodriguez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649272055 PECOS PAC ID: 8628973377 Enrollment ID: I20031204001088 |
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