Healthcare Provider Details

I. General information

NPI: 1528228988
Provider Name (Legal Business Name): JUAN MERAYO-RODRIGUEZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2008
Last Update Date: 04/11/2024
Certification Date: 04/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4039 W NEWBERRY RD
GAINESVILLE FL
32607-2342
US

IV. Provider business mailing address

4039 W NEWBERRY RD
GAINESVILLE FL
32607-2342
US

V. Phone/Fax

Practice location:
  • Phone: 352-224-1747
  • Fax: 888-286-0179
Mailing address:
  • Phone: 352-224-1747
  • Fax: 888-286-0179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZB0001X
TaxonomyBlood Banking & Transfusion Medicine Physician
License NumberME111999
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207ZB0001X
TaxonomyBlood Banking & Transfusion Medicine Physician
License NumberMD.32033
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code207ZB0001X
TaxonomyBlood Banking & Transfusion Medicine Physician
License Number69039
License Number StateGA
# 4
Primary TaxonomyY
Taxonomy Code207ZB0001X
TaxonomyBlood Banking & Transfusion Medicine Physician
License NumberMT192408
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: