Provider Demographics
NPI:1235531666
Name:RODRIGUEZ, CASSANDRA DANIELLE (NP)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:DANIELLE
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5563 CHANTERELLE CIR
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32583-1655
Mailing Address - Country:US
Mailing Address - Phone:859-391-9569
Mailing Address - Fax:
Practice Address - Street 1:9310 FOWLER AVE
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32534-1852
Practice Address - Country:US
Practice Address - Phone:850-430-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-17
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN18897363LF0000X
FLAPRN11020689363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily