Provider Demographics
NPI:1225008063
Name:LAWSON, RODOLFO EDUARDO (MD)
Entity Type:Individual
Prefix:
First Name:RODOLFO
Middle Name:EDUARDO
Last Name:LAWSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:RODOLFO
Other - Middle Name:E
Other - Last Name:LAWSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, PA
Mailing Address - Street 1:7150 W 20TH AVE STE 313
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5532
Mailing Address - Country:US
Mailing Address - Phone:308-820-6000
Mailing Address - Fax:305-364-1295
Practice Address - Street 1:7150 W 20TH AVE STE 313
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-5532
Practice Address - Country:US
Practice Address - Phone:308-820-6000
Practice Address - Fax:305-364-1295
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0035484174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME 0035484OtherSTATE MEDICAL LICENSE
FLME 0035484OtherSTATE MEDICAL LICENSE
FL07802AMedicare ID - Type Unspecified