Provider Demographics
NPI:1063040814
Name:GARCIA ROLDAN, ERILEEN XIOMARA (MD)
Entity Type:Individual
Prefix:
First Name:ERILEEN
Middle Name:XIOMARA
Last Name:GARCIA ROLDAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3661 S MIAMI AVE STE 803
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-4223
Mailing Address - Country:US
Mailing Address - Phone:786-600-4733
Mailing Address - Fax:786-724-4889
Practice Address - Street 1:3661 S MIAMI AVE STE 803
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4223
Practice Address - Country:US
Practice Address - Phone:786-600-4733
Practice Address - Fax:786-724-4889
Is Sole Proprietor?:No
Enumeration Date:2020-03-28
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME161433208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics