Provider Demographics
NPI:1346382934
Name:RODRIGUEZ, FELIX ALBERTO (MD)
Entity type:Individual
Prefix:DR
First Name:FELIX
Middle Name:ALBERTO
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 1:61 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:NY
Mailing Address - Zip Code:10803-1027
Mailing Address - Country:US
Mailing Address - Phone:914-738-2278
Mailing Address - Fax:
Practice Address - Street 1:385 FORT WASHINGTON AVE
Practice Address - Street 2:SUITE 9
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-6740
Practice Address - Country:US
Practice Address - Phone:212-923-3832
Practice Address - Fax:212-923-2760
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207751207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG64120Medicare UPIN
NY29N321Medicare ID - Type Unspecified
NY29N322Medicare ID - Type Unspecified