Healthcare Provider Details

I. General information

NPI: 1841229697
Provider Name (Legal Business Name): METRO MEDICAL RESEARCH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2687 SW 25TH TER
MIAMI FL
33133-2220
US

IV. Provider business mailing address

2687 SW 25TH TER
MIAMI FL
33133-2220
US

V. Phone/Fax

Practice location:
  • Phone: 305-856-9777
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberHCC6897
License Number StateFL

VIII. Authorized Official

Name: ANTONIO RODRIGUES
Title or Position: PRESIDENT
Credential:
Phone: 305-856-9777