Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Wilson Omar Rodriguez, PA

Individual provider Physician Assistant · NPI 1063268209

Dr. Wilson Omar Rodriguez, PA is a Physician Assistant in Winter Haven, Florida. Licensed in Florida and Puerto Rico. Registered with an NPI since 2024.

Licensed in
FL, PR
In the registry since
2024
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

217 E Central Ave
Winter Haven, FL 33880-6312
Phone: (407) 315-3637
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence TPPA690 (FL)
Physician Assistant Taxonomy 363A00000X · Licence 2146-PA (PR)

Record details

NPI number1063268209
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedApril 29, 2024
Last updated in NPPESMay 24, 2024
Certification dateMay 24, 2024

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