MEDICARE: R & M MEDICAL CENTER, CORP.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1366493363
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	R & M MEDICAL CENTER, CORP.

Provider Business Mailing Address
First Line	:	3750 W 16TH AVE
Second Line	:	SUITE 130-U
City	:	HIALEAH
State	:	FL
Zip	:	33012-4654
Country	:	US
Telephone Number	:	305-828-8189
Fax Number	:	305-828-9938

Provider Business Practice Location Address
First Line	:	3750 W 16TH AVE
Second Line	:	SUITE 130-U
City	:	HIALEAH
State	:	FL
Zip	:	33012-4654
Country	:	US
Telephone Number	:	305-828-8189
Fax Number	:	305-828-9938

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JOSE RODRIGUEZ
Credential	:
Telephone Number	:	305-828-8189

Provider Enumeration Date	:	05/14/2006
Last Update Date	:	05/12/2008

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