| Rodrigo Baltodano Inc | |
|
3125 Citrus Tower Boulevard Bldg C Clermont FL 34711 | |
| (352) 394-0043 | |
| (352) 394-0640 |
| Full Name | Rodrigo Baltodano Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3125 Citrus Tower Boulevard, Clermont, Florida |
| Authorized Official Name and Position | Rodrigo Baltodano (OWNER) |
| Authorized Official Contact | 3523940043 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rodrigo Baltodano Inc 3125 Citrus Tower Blvd Clermont FL 34711-6803 Ph: (352) 394-0043 | Rodrigo Baltodano Inc 3125 Citrus Tower Boulevard Bldg C Clermont FL 34711 Ph: (352) 394-0043 |
| NPI Number | 1265446918 |
|---|---|
| Provider Enumeration Date | 07/28/2006 |
| Last Update Date | 12/22/2011 |
| Medicare PECOS PAC ID | 3577595537 |
|---|---|
| Medicare Enrollment ID | O20050910000000 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265446918 | NPI | - | NPPES |
| 6179630001 | Other | FL | DMEPOS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME88226 (Florida) | Primary |
| Provider Name | Rodrigo Baltodano |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942225164 PECOS PAC ID: 3971580036 Enrollment ID: I20040707000062 |
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