Healthcare Provider Details

I. General information

NPI: 1578509642
Provider Name (Legal Business Name): RIGOBERTO PENA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6510 N UNIVERSITY DR
TAMARAC FL
33321-4001
US

IV. Provider business mailing address

6510 N UNIVERSITY DR
TAMARAC FL
33321-4001
US

V. Phone/Fax

Practice location:
  • Phone: 954-417-4499
  • Fax: 954-210-8074
Mailing address:
  • Phone: 954-417-4499
  • Fax: 954-210-8074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME93488
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: