Provider Demographics
NPI:1396255857
Name:RODRIGUEZ, RAUL ALEJANDRO (FNP)
Entity type:Individual
Prefix:MR
First Name:RAUL
Middle Name:ALEJANDRO
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5350 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-8112
Mailing Address - Country:US
Mailing Address - Phone:561-496-6000
Mailing Address - Fax:561-496-6049
Practice Address - Street 1:5350 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-8112
Practice Address - Country:US
Practice Address - Phone:561-496-6000
Practice Address - Fax:561-496-6049
Is Sole Proprietor?:No
Enumeration Date:2017-10-10
Last Update Date:2025-05-23
Deactivation Date:2025-05-07
Deactivation Code:
Reactivation Date:2025-05-23
Provider Licenses
StateLicense IDTaxonomies
FL9297017363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily