Susely C. Rodriguez PA-C
Physician Assistant in Melbourne, FL(View on Map)
Full Name
Susely C Rodriguez PA-C
NPI Number
1750036455
NPI Type
Individual Provider
Gender
Female
Enumeration Date
02/21/2022
Specialties
(Taxonomies)Code
363A00000X
363AM0700X
363AS0400X
Primary Taxonomy
Yes
No
No
Licenses
State
Florida
License Number
9115448
Contact
Information
Purpose
Mailing
Location
Address
7208 WANDO AVE
1250 S HARBOR CITY BLVD
City
Grant
Melbourne
State
FL
FL
Postal Code
32949-5350
32901-3242
Country
US
US
Telephone Number
(321) 986-9152
(321) 725-8919
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 02/21/2022
Provider Address
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