Provider Demographics
NPI:1043458326
Name:BARDINAS RODRIGUEZ, ROGELIO OSCAR (MD)
Entity Type:Individual
Prefix:
First Name:ROGELIO
Middle Name:OSCAR
Last Name:BARDINAS RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3148 SW 143RD PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-7435
Mailing Address - Country:US
Mailing Address - Phone:786-201-1548
Mailing Address - Fax:305-441-9702
Practice Address - Street 1:5200 SW 8TH ST
Practice Address - Street 2:SUITE # 150
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2300
Practice Address - Country:US
Practice Address - Phone:305-250-5600
Practice Address - Fax:305-250-5688
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-26
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME106246207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME106246OtherMEDICAL LICENCE