Individual ProviderJennifer RodriguezPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address250 E Dunlap Ave, Phoenix, AZ 85020-2825(480) 331-6721PECOS EnrollmentBased on the most recent information from CMS, provider Jennifer Rodriguez is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1225736507Provider TypeIndividualFull NameRodriguez, JenniferGenderFemaleSole ProprietorNoEnumeration Date2/16/2023Last Updated8/18/2024Contact InformationPractice LocationPractice Address250 E Dunlap Ave, Phoenix, AZ 85020-2825Phone(480) 331-6721Fax(602) 296-7738Mailing LocationMailing Address111 E Dunlap Ave Ste I-279, Phoenix, AZ 85020-2807Phone(480) 331-6721Fax(480) 296-7738Provider TaxonomiesCodeDescriptionLicenseCode363A00000XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicenseUnlisted Issuer