Provider Demographics
NPI:1871582932
Name:RODRIGUEZ, SUZETTE MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:SUZETTE
Middle Name:MARIE
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 1:603 N FLAMINGO RD
Mailing Address - Street 2:SUITE 361
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-1023
Mailing Address - Country:US
Mailing Address - Phone:954-432-7900
Mailing Address - Fax:954-433-4903
Practice Address - Street 1:603 N FLAMINGO RD
Practice Address - Street 2:SUITE 361
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-1023
Practice Address - Country:US
Practice Address - Phone:954-432-7900
Practice Address - Fax:954-433-4903
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2009-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME92267207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL276098300Medicaid