Most Relevant Information
Provider Data
| NPI Number: | 1003458530 |
| Provider Name: | BLANCA LIDIA RODRIGUEZ |
| Entity Type: | Individual |
| Taxonomy Code: | 3747P1801X |
| Specialty: | Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/16/2019 |
| Last Updated: | 10/16/2019 |
Provider Practice Location
2330 PASEO DEL PRADO STE C307
LAS VEGAS
NV
891020076
Practice Location Phone/Fax
| Phone: | 7256007953 |
| Fax: |
Provider Mailing Location
1709 ANZIO ST
LAS VEGAS
NV
891082323
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |