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NPI Code Detail

MEDICARE: ERNESTO RODRIGUEZ VALDES MD INC

MEDICARE: ERNESTO RODRIGUEZ VALDES MD 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
1207Q00000XFamily Medicine PhysicianME111630FL

General Provider Information

NPI Number : 1598020018
Entity Type Code : Organization
Provider Name (Legal Business Name) : ERNESTO RODRIGUEZ VALDES MD INC
Provider Business Mailing Address
First Line : 11370 SW 122ND ST
Second Line :
City : MIAMI
State : FL
Zip : 33176-4425
Country : US
Telephone Number : 786-383-7671
Fax Number : 305-428-2661
Provider Business Practice Location Address
First Line : 11370 SW 122ND ST
Second Line :
City : MIAMI
State : FL
Zip : 33176-4425
Country : US
Telephone Number : 786-383-7671
Fax Number : 305-428-2661
Authorized Official
Title or Position : PRESIDENT
Name : DR. ERNESTO RODRIGUEZ VALDES
Credential : MD
Telephone Number : 786-383-7671
Provider Enumeration Date : 07/10/2012
Last Update Date : 07/10/2012

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