Healthcare Provider Details

I. General information

NPI: 1225613417
Provider Name (Legal Business Name): RODOLFO JOSE URRUELA-BARRIOS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2021
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1475 W 14TH ST.
HIALEAH FL
33012
US

IV. Provider business mailing address

9761 SW 56TH TER
MIAMI FL
33173-1485
US

V. Phone/Fax

Practice location:
  • Phone: 305-558-2500
  • Fax:
Mailing address:
  • Phone: 786-972-7243
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberME169679
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME169679
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: