MEDICARE: DR. LUIS RAUL MACEIRA-RODRIGUEZ MD

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	207P00000X	Emergency Medicine Physician	ME60036	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	12489	OTHER	FL	BCBS GROUP # 45262
4	12489	OTHER	FL	GROUP # 72076
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831193770
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUIS RAUL MACEIRA-RODRIGUEZ MD

Provider Business Mailing Address
First Line	:	2896 SUMMER SWAN DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32825-7404
Country	:	US
Telephone Number	:	407-207-2146
Fax Number	:

Provider Business Practice Location Address
First Line	:	2896 SUMMER SWAN DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32825-7404
Country	:	US
Telephone Number	:	407-207-2146
Fax Number	:

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

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	02/19/2014

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