| Ivan R Rodriguez Md Pa | |
|
12002 Sw 128th Ct Ste 204 Miami FL 33186-4643 | |
| (305) 234-8264 | |
| (305) 255-1752 |
| Full Name | Ivan R Rodriguez Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 12002 Sw 128th Ct Ste 204, Miami, Florida |
| Authorized Official Name and Position | Ivan R Rodriguez (OWNER/PRESIDENT) |
| Authorized Official Contact | 3052348264 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ivan R Rodriguez Md Pa 12002 Sw 128th Ct Ste 204 Miami FL 33186-4643 Ph: (305) 234-8264 | Ivan R Rodriguez Md Pa 12002 Sw 128th Ct Ste 204 Miami FL 33186-4643 Ph: (305) 234-8264 |
| NPI Number | 1235775883 |
|---|---|
| Provider Enumeration Date | 11/19/2019 |
| Last Update Date | 01/30/2023 |
| Medicare PECOS PAC ID | 3173959665 |
|---|---|
| Medicare Enrollment ID | O20200131000470 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235775883 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Ivan R Rodriguez Kalaf |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205260221 PECOS PAC ID: 1850688821 Enrollment ID: I20200131000671 |
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