=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972646164
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RIGOBERTO REGUERO CORP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/15/2007
-----------------------------------------------------
Last Update Date | 01/12/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5200 SW 8TH ST STE 205A
-----------------------------------------------------
City | CORAL GABLES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33134-2337
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-649-1700
-----------------------------------------------------
Fax | 786-621-1808
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5200 SW 8TH ST STE 205A
-----------------------------------------------------
City | CORAL GABLES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33134-2337
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-649-1700
-----------------------------------------------------
Fax | 786-621-1808
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | RIGOBERTO REGUERO
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 305-649-1700
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208D00000X
-----------------------------------------------------
Taxonomy Name | General Practice Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------