Healthcare Provider Details

I. General information

NPI: 1033372073
Provider Name (Legal Business Name): RODRIGO BELALCAZAR ARDILA M.D.,
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2008
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1840 W 49TH ST STE 601
HIALEAH FL
33012-2962
US

IV. Provider business mailing address

1840 W 49TH ST STE 601
HIALEAH FL
33012-2962
US

V. Phone/Fax

Practice location:
  • Phone: 305-794-2744
  • Fax:
Mailing address:
  • Phone: 305-794-2744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME 105283
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME 105283
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number249662
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number249662
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberM9848
License Number StateTX
# 6
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number062187
License Number StateGA
# 7
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberM9848
License Number StateTX
# 8
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number062187
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: