Provider Demographics
NPI:1215313366
Name:RODRIGUEZ, JOANN GAMA
Entity type:Individual
Prefix:
First Name:JOANN
Middle Name:GAMA
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6225 N 30TH WAY
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-2212
Mailing Address - Country:US
Mailing Address - Phone:602-625-7771
Mailing Address - Fax:
Practice Address - Street 1:7425 E SHEA BLVD
Practice Address - Street 2:STE 103
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6411
Practice Address - Country:US
Practice Address - Phone:480-905-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-30
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist