Provider Demographics
NPI:1316695190
Name:RODRIGUEZ, JASON ABRAHAM (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:ABRAHAM
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16070 SW 71ST TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-3480
Mailing Address - Country:US
Mailing Address - Phone:786-603-7794
Mailing Address - Fax:
Practice Address - Street 1:9510 SW 160TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-3300
Practice Address - Country:US
Practice Address - Phone:305-971-9797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-11
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS63835183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist