NPI 1174884340

Wilson Rodriguez, IDC

Practitioner Independent Duty Corpsman Cleveland, OH

Practice location

Address: 19165 Puritas Ave, Cleveland, OH 44135-1031
Phone: (216) 849-7987

Registered specialties

Independent Duty Corpsman Primary

Other Service Providers Taxonomy 1710I1002X

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Registry record

NPI: 1174884340
Entity type: Individual
Sex (as registered): Male
NPI issued: 5 Jun 2012
Record last updated: 5 Jun 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.