Provider Demographics
NPI:1609413434
Name:RODRIGUEZ, FELIX JUAN
Entity type:Individual
Prefix:MR
First Name:FELIX
Middle Name:JUAN
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 1:1795 W 25TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44113-3112
Mailing Address - Country:US
Mailing Address - Phone:216-220-8774
Mailing Address - Fax:
Practice Address - Street 1:1795 W 25TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44113-3112
Practice Address - Country:US
Practice Address - Phone:216-220-8774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-27
Last Update Date:2019-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist