MEDICARE: KEROD MEDICAL SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QA0505X	Adult Medicine Physician

General Provider Information

NPI Number	:	1194319848
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KEROD MEDICAL SERVICES INC

Provider Business Mailing Address
First Line	:	1066 NE 85TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33138-3426
Country	:	US
Telephone Number	:	305-491-6124
Fax Number	:

Provider Business Practice Location Address
First Line	:	1066 NE 85TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33138-3426
Country	:	US
Telephone Number	:	305-491-6124
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	GUSTAVO RODRIGUEZ
Credential	:
Telephone Number	:	305-491-6124

Provider Enumeration Date	:	02/23/2021
Last Update Date	:	03/08/2021

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Directions to “KEROD MEDICAL SERVICES INC ” Practice Location

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