Provider Demographics
NPI:1871548313
Name:RODRIGUEZ RODRIGUEZ, CARMEN MILAGROS (MD)
Entity type:Individual
Prefix:DR
First Name:CARMEN
Middle Name:MILAGROS
Last Name:RODRIGUEZ 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 1:7910 CITRUS GARDEN DR APT 102
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33625-2464
Mailing Address - Country:US
Mailing Address - Phone:787-424-9038
Mailing Address - Fax:
Practice Address - Street 1:7910 CITRUS GARDEN DR APT 102
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33625-2464
Practice Address - Country:US
Practice Address - Phone:787-424-9038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1469922084P0805X
PR77442084P0805X
MA10179422084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR7744OtherLICENCE
FLME-146992OtherMEDICAL LICENSE
MA1017942OtherMEDICAL LICENSE