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General NPI Number Information
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NPI Number | 1790678316
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Entity Type | Organization
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Legal Business Name | R.R.D.R. MEDICAL GROUP, INC
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Dates
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Enumeration Date | 06/02/2025
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 2150 W 68TH ST STE 200
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City | HIALEAH GARDENS
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State | FL
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Zip | 33016-1802
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Country | US
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Telephone | 786-805-3129
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Fax |
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Provider Business Mailing Address
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Address Line | 2150 W 68TH ST STE 200
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City | HIALEAH GARDENS
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State | FL
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Zip | 33016-1802
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Country | US
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Telephone | 786-805-3129
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RAUL A TAMAYO
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Credential | MD
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Telephone | 305-445-9351
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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