Provider Demographics
NPI:1528864634
Name:RODRIGUEZ, HUGO GUILLERMO
Entity type:Individual
Prefix:
First Name:HUGO
Middle Name:GUILLERMO
Last Name:RODRIGUEZ
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 1:860 SANCTUARY COVE DR
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4523
Mailing Address - Country:US
Mailing Address - Phone:310-980-5933
Mailing Address - Fax:
Practice Address - Street 1:860 SANCTUARY COVE DR
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33410-4523
Practice Address - Country:US
Practice Address - Phone:310-980-5933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-20
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL31004122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist