Healthcare Provider Details

I. General information

NPI: 1699079202
Provider Name (Legal Business Name): CARLOS LORENZO RODRIGUEZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/23/2010
Last Update Date: 07/12/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8040 NW 95TH ST STE 331-332
HIALEAH GARDENS FL
33016-2362
US

IV. Provider business mailing address

8445 NW 169TH TER
MIAMI LAKES FL
33016-6160
US

V. Phone/Fax

Practice location:
  • Phone: 305-785-0231
  • Fax: 305-819-1116
Mailing address:
  • Phone: 305-785-0231
  • Fax: 305-819-1116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME106903
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME106903
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: