Provider Demographics
NPI:1699457036
Name:RODRIGUEZ, CHRISTIAN ULIS
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:ULIS
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 1:1515 SWEET APPLE ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:34787-3771
Mailing Address - Country:US
Mailing Address - Phone:407-394-5066
Mailing Address - Fax:
Practice Address - Street 1:13900 COUNTY ROAD 455 UNIT 112
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-9020
Practice Address - Country:US
Practice Address - Phone:407-554-3390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-04
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS5738237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist