Healthcare Provider Details

I. General information

NPI: 1831163799
Provider Name (Legal Business Name): EDUARDO RAGOLTA JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7500 SW 8TH ST SUITE 204
MIAMI FL
33144-4400
US

IV. Provider business mailing address

7500 SW 8TH ST SUITE 204
MIAMI FL
33144-4400
US

V. Phone/Fax

Practice location:
  • Phone: 305-262-0003
  • Fax: 305-262-5353
Mailing address:
  • Phone: 305-262-0003
  • Fax: 305-262-5353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME53249
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberME53249
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: