MEDICARE: MARA MILAGROS RODRIGUEZ 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	207R00000X	Internal Medicine Physician	ME111166	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518242346
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARA MILAGROS RODRIGUEZ M.D.

Provider Business Mailing Address
First Line	:	3850 SW 87TH AVE STE 205
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-5473
Country	:	US
Telephone Number	:	786-452-9095
Fax Number	:	786-452-9163

Provider Business Practice Location Address
First Line	:	3850 SW 87TH AVE STE 205
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-5473
Country	:	US
Telephone Number	:	786-452-9095
Fax Number	:	786-452-9163

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

Provider Enumeration Date	:	10/12/2011
Last Update Date	:	02/28/2024

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