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Contact Information

IVAN LAVANDERA RODRIGUEZ
1995 E OAKLAND PARK BLVD STE 310
FORT LAUDERDALE, FL33306-1138
 Phone: 954-791-6146
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Surgical

363AS0400X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for IVAN LAVANDERA RODRIGUEZ · (Male)

NPI Number 1417311622
Status Active
Credentials
Entity Individual
Enumeration date 04/13/2016
Last updated 04/05/2021 - About 5 years ago
Sole proprietor 1 Yes
Identifiers
  • FL License # 11012299
  • FL License # 15-528
Hospital affiliation(s)
  • MEMORIAL HOSPITAL WEST - (Acute Care)
    703 N FLAMINGO RD
    PEMBROKE PINES, FL 33028
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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