MEDICARE: DR. MAURICIO RICARDO MONRROY PRADO M.D.

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	207RN0300X	Nephrology Physician	0101251095	VA

General Provider Information

NPI Number	:	1285836353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MAURICIO RICARDO MONRROY PRADO M.D.

Provider Business Mailing Address
First Line	:	951 BRICKELL AVE APT 703
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33131-3933
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3806 MECHANICSVILLE TPKE
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23223-1114
Country	:	US
Telephone Number	:	804-228-1143
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2007
Last Update Date	:	08/26/2012

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