Provider Demographics
NPI:1538277090
Name:RODRIGUEZ, SANDRA ISABEL (MD)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:ISABEL
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1503 BILL BECK BLVD
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-9516
Mailing Address - Country:US
Mailing Address - Phone:407-943-8618
Mailing Address - Fax:
Practice Address - Street 1:1507 BILL BECK BLVD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-9516
Practice Address - Country:US
Practice Address - Phone:407-943-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-26
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA90195207R00000X
FLME108407207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003332500Medicaid
CAA901950Medicare PIN
FL003332500Medicaid