Provider Demographics
NPI:1871608885
Name:RODRIGUEZ, REY L (MD)
Entity type:Individual
Prefix:DR
First Name:REY
Middle Name:L
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2234 COLONIAL BLVD
Mailing Address - Street 2:ATTN: MANAGED CARE DEPT.
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1412
Mailing Address - Country:US
Mailing Address - Phone:239-931-7342
Mailing Address - Fax:239-931-7385
Practice Address - Street 1:7340 E THOMAS RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-7216
Practice Address - Country:US
Practice Address - Phone:480-945-6896
Practice Address - Fax:480-945-7287
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ438202085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ99S006800014OtherMEDISUN ONE
AZP00900578OtherRAILROAD MEDICARE
AZ6484497OtherCIGNA
AZ590059Medicaid
AZ743205OtherARIZONA FOUNDATION CATHOLIC HC
AZ3Z4670OtherHEALTH NET
AZ5970209OtherAETNA
AZ5970209OtherAETNA
AZ743205OtherARIZONA FOUNDATION CATHOLIC HC
AZZ142436Medicare PIN