Provider Demographics
NPI:1831692052
Name:RODRIGUEZ, LILLIAN OLIVIA (BILLING MANAGER)
Entity type:Individual
Prefix:
First Name:LILLIAN
Middle Name:OLIVIA
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:BILLING MANAGER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1141 E 3900 S STE 150A
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84124-1215
Mailing Address - Country:US
Mailing Address - Phone:801-273-6401
Mailing Address - Fax:801-273-6402
Practice Address - Street 1:1141 E 3900 S
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84124-1215
Practice Address - Country:US
Practice Address - Phone:801-273-6401
Practice Address - Fax:801-273-6302
Is Sole Proprietor?:No
Enumeration Date:2018-03-14
Last Update Date:2018-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker