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General NPI Number Information
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NPI Number | 1235279076
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Entity Type | Organization
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Legal Business Name | LEUNAM RODRIGUEZ MD PA
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 11/16/2009
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Provider Practice Location Address
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Address Line | 1150 CAMPO SANO AVE SUITE 420
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City | CORAL GABLES
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State | FL
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Zip | 33146-1174
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Country | US
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Telephone | 305-663-0088
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Fax | 305-663-1933
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Provider Business Mailing Address
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Address Line | 1150 CAMPO SANO AVE SUITE 420
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City | CORAL GABLES
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State | FL
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Zip | 33146-1174
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Country | US
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Telephone | 305-663-0088
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Fax | 305-663-1933
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LEUNAM J RODRIGUEZ
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Credential | M.D.
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Telephone | 305-663-0088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | ME93811
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License Number State | FL
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