Provider Demographics
NPI:1174301634
Name:RODRIGUEZ MOREIRA, OSLANYER ANAEL (SA-C)
Entity type:Individual
Prefix:
First Name:OSLANYER
Middle Name:ANAEL
Last Name:RODRIGUEZ MOREIRA
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10090 NW 80TH CT APT 1222
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33016-2238
Mailing Address - Country:US
Mailing Address - Phone:786-298-4438
Mailing Address - Fax:
Practice Address - Street 1:10090 NW 80TH CT APT 1222
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33016-2238
Practice Address - Country:US
Practice Address - Phone:786-298-4438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23-631246ZC0007X
FL23631246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant