MEDICARE: MR. INALDO LAZARO RODRIGUEZ L.M.T.

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	171W00000X	Contractor	LMT 31170	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	LMT 31170	OTHER	FL	INDEPENDENT

General Provider Information

NPI Number	:	1770871360
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. INALDO LAZARO RODRIGUEZ L.M.T.

Provider Business Mailing Address
First Line	:	9436 SW 5TH LN
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33174-2114
Country	:	US
Telephone Number	:	305-370-9408
Fax Number	:

Provider Business Practice Location Address
First Line	:	9436 SW 5TH LN
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33174-2114
Country	:	US
Telephone Number	:	305-370-9408
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/16/2011
Last Update Date	:	07/16/2011

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