Provider Demographics
NPI:1417524315
Name:RODRIGUEZ PEREZ, ALBERTO
Entity type:Individual
Prefix:
First Name:ALBERTO
Middle Name:
Last Name:RODRIGUEZ PEREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2748 SW 21ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-2306
Mailing Address - Country:US
Mailing Address - Phone:786-770-1747
Mailing Address - Fax:
Practice Address - Street 1:8333 W MCNAB RD STE 207
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-3203
Practice Address - Country:US
Practice Address - Phone:786-770-1747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management