Healthcare Provider Details

I. General information

NPI: 1578479598
Provider Name (Legal Business Name): HOPE MEDICAL GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5008 W NORTHERN AVE STE 14
GLENDALE AZ
85301-1570
US

IV. Provider business mailing address

15013 SW 63RD ST
MIAMI FL
33193-2772
US

V. Phone/Fax

Practice location:
  • Phone: 786-554-2254
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: YAQUELIN RODRIGUEZ
Title or Position: OWNER
Credential: PA
Phone: 786-554-2254