Provider Demographics
NPI:1588711659
Name:HEALTH ON DEMAND (RODRIGUEZ) PC
Entity type:Organization
Organization Name:HEALTH ON DEMAND (RODRIGUEZ) PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRYN
Authorized Official - Middle Name:M
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-350-1463
Mailing Address - Street 1:5771 S FORT APACHE RD STE 120
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-5626
Mailing Address - Country:US
Mailing Address - Phone:702-614-1250
Mailing Address - Fax:702-489-2099
Practice Address - Street 1:9750 W SKYE CANYON PARK DR STE 160-287
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89166-6623
Practice Address - Country:US
Practice Address - Phone:702-350-1463
Practice Address - Fax:702-470-1815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV103583Medicare PIN