Provider Demographics
NPI:1417768284
Name:RODRIGUEZ GARCIA, MARIO ROBERTO (RN)
Entity type:Individual
Prefix:MR
First Name:MARIO
Middle Name:ROBERTO
Last Name:RODRIGUEZ GARCIA
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13250 SW 58TH TER APT 10-9
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-1256
Mailing Address - Country:US
Mailing Address - Phone:786-458-1043
Mailing Address - Fax:
Practice Address - Street 1:13250 SW 58TH TER APT 10-9
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-1256
Practice Address - Country:US
Practice Address - Phone:786-458-1043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-20
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9676226163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse