Healthcare Provider Details

I. General information

NPI: 1609336007
Provider Name (Legal Business Name): ANA MARIA IGLESIAS RODRIGUEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2019
Last Update Date: 08/09/2022
Certification Date: 08/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13611 SW 74TH ST
MIAMI FL
33183-3117
US

IV. Provider business mailing address

13611 SW 74TH ST
MIAMI FL
33183-3117
US

V. Phone/Fax

Practice location:
  • Phone: 786-715-9183
  • Fax: 786-713-1115
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberME152974
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: