Provider Demographics
NPI:1215700380
Name:RODRIGUEZ OCASIO, RAFAEL E (MD)
Entity type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:E
Last Name:RODRIGUEZ OCASIO
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4855 W HILLSBORO BLVD STE B2
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-4356
Mailing Address - Country:US
Mailing Address - Phone:689-588-5588
Mailing Address - Fax:
Practice Address - Street 1:2090 OLD HICKORY TREE RD STE 107
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34772-8901
Practice Address - Country:US
Practice Address - Phone:689-588-5588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-01
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR24198208D00000X
FLACN1698208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice