MEDICARE: MANAS MEDICAL CENTER, CORP

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	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1598795726
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MANAS MEDICAL CENTER, CORP

Provider Business Mailing Address
First Line	:	7801 CORAL WAY
Second Line	:	SUITE 122
City	:	MIAMI
State	:	FL
Zip	:	33155-6538
Country	:	US
Telephone Number	:	305-269-6788
Fax Number	:

Provider Business Practice Location Address
First Line	:	7801 CORAL WAY
Second Line	:	SUITE 122
City	:	MIAMI
State	:	FL
Zip	:	33155-6538
Country	:	US
Telephone Number	:	305-269-6788
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ISLAY L RODRIGUEZ
Credential	:	PA
Telephone Number	:	305-269-6788

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	08/22/2020

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