Provider Demographics
NPI:1699079202
Name:RODRIGUEZ, CARLOS LORENZO (MD)
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:LORENZO
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1485 W 46TH ST
Mailing Address - Street 2:APT 518
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-7199
Mailing Address - Country:US
Mailing Address - Phone:305-785-0231
Mailing Address - Fax:
Practice Address - Street 1:1485 W 46TH ST
Practice Address - Street 2:APT 518
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-7199
Practice Address - Country:US
Practice Address - Phone:305-785-0231
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-23
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME106903207P00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine