| Rodriguez Clinic And Foundation Llc | |
|
4421 Conlin St Suite 101 Metairie LA 70006-2154 | |
| (504) 455-2002 | |
| (504) 885-4383 |
| Full Name | Rodriguez Clinic And Foundation Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4421 Conlin St, Metairie, Louisiana |
| Authorized Official Name and Position | Jose M. Rodriguez (MANAGER) |
| Authorized Official Contact | 5044552002 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rodriguez Clinic And Foundation Llc 4421 Conlin St Suite 101 Metairie LA 70006-2154 Ph: (504) 455-2002 | Rodriguez Clinic And Foundation Llc 4421 Conlin St Suite 101 Metairie LA 70006-2154 Ph: (504) 455-2002 |
| NPI Number | 1609001999 |
|---|---|
| Provider Enumeration Date | 05/15/2009 |
| Last Update Date | 04/15/2016 |
| Medicare PECOS PAC ID | 3476877887 |
|---|---|
| Medicare Enrollment ID | O20150113000688 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609001999 | NPI | - | NPPES |
| 1075353 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 202660 (Louisiana) | Primary |
| Provider Name | Jose Rodriguez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235399262 PECOS PAC ID: 4789727231 Enrollment ID: I20100205000061 |
| Provider Name | Shanta Marie Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427468503 PECOS PAC ID: 9436379922 Enrollment ID: I20141006000376 |
| Provider Name | Amanda S Eymard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790162626 PECOS PAC ID: 7214241850 Enrollment ID: I20150727002505 |
| Provider Name | Hali R Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700330396 PECOS PAC ID: 7719267236 Enrollment ID: I20161129001244 |
| Provider Name | Brealon M Lirette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710400833 PECOS PAC ID: 8820363153 Enrollment ID: I20171012000093 |
| Provider Name | Lilia A Arcement |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184276735 PECOS PAC ID: 2163858150 Enrollment ID: I20200211002361 |
| Provider Name | Ryan Michael Kelley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346855517 PECOS PAC ID: 4183044480 Enrollment ID: I20201026000500 |
| Provider Name | Sauntrice O'quin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194246686 PECOS PAC ID: 3870850563 Enrollment ID: I20201118000548 |
| Provider Name | Wendell Perry Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477950434 PECOS PAC ID: 0042622771 Enrollment ID: I20201222000124 |
| Provider Name | Holly S Mollere |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235689654 PECOS PAC ID: 9335516608 Enrollment ID: I20221031001638 |
| Provider Name | Michele R Rassbach |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255604039 PECOS PAC ID: 6406205848 Enrollment ID: I20231212000260 |
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