Provider Demographics
NPI:1144590316
Name:RODOLFO A. CHIRINOS, M.D., P.A.
Entity Type:Organization
Organization Name:RODOLFO A. CHIRINOS, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:OTILIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIRINOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-587-0257
Mailing Address - Street 1:7050 NW 4TH ST
Mailing Address - Street 2:#302
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2247
Mailing Address - Country:US
Mailing Address - Phone:954-587-0257
Mailing Address - Fax:954-587-0390
Practice Address - Street 1:7050 NW 4TH ST
Practice Address - Street 2:#302
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2247
Practice Address - Country:US
Practice Address - Phone:954-587-0257
Practice Address - Fax:954-587-0390
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RODOLFO A. CHIRINOS, M.D., P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-01-05
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0026857207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL057489900Medicaid
FL93309OtherBLUE CROSS BLUE SHIELD
FL93309Medicare PIN
FL057489900Medicaid