Provider Demographics
NPI:1033971908
Name:GENERAL SURGERY MD LLC
Entity Type:Organization
Organization Name:GENERAL SURGERY MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LORENZO
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-609-4157
Mailing Address - Street 1:16836 NW 91ST AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33018-6324
Mailing Address - Country:US
Mailing Address - Phone:305-609-4157
Mailing Address - Fax:
Practice Address - Street 1:16836 NW 91ST AVE
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33018-6324
Practice Address - Country:US
Practice Address - Phone:305-609-4157
Practice Address - Fax:786-464-0594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-26
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty