Healthcare Provider Details

I. General information

NPI: 1437397817
Provider Name (Legal Business Name): LEONARDO RODRIGUEZ M.D. P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2009
Last Update Date: 01/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 ARTHUR GODFREY RD SUITE 202
MIAMI BEACH FL
33140-3641
US

IV. Provider business mailing address

333 ARTHUR GODFREY RD SUITE 202
MIAMI BEACH FL
33140-3641
US

V. Phone/Fax

Practice location:
  • Phone: 305-674-3515
  • Fax:
Mailing address:
  • Phone: 305-674-3515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME98691
License Number StateFL

VIII. Authorized Official

Name: DR. LEONARDO RODRIGUEZ
Title or Position: PRESIDENT
Credential: M.D.
Phone: 305-674-3515