MEDICARE: JESUS RAMON RODRIGUEZ DE LA TORRE MD

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	ME0050089	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	:	1861489726
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESUS RAMON RODRIGUEZ DE LA TORRE MD

Provider Business Mailing Address
First Line	:	7801 SW 24TH ST
Second Line	:	SUITE 115
City	:	MIAMI
State	:	FL
Zip	:	33155-6538
Country	:	US
Telephone Number	:	305-534-9009
Fax Number	:	305-907-5919

Provider Business Practice Location Address
First Line	:	7801 SW 24TH ST
Second Line	:	SUITE 115
City	:	MIAMI
State	:	FL
Zip	:	33155-6538
Country	:	US
Telephone Number	:	305-534-9009
Fax Number	:	305-907-5919

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

Provider Enumeration Date	:	10/05/2005
Last Update Date	:	11/30/2016

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