Provider Demographics
NPI:1366861809
Name:PA PROFESSIONAL CARE INC
Entity Type:Organization
Organization Name:PA PROFESSIONAL CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RUBIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-606-7516
Mailing Address - Street 1:7969 NW 2ND ST
Mailing Address - Street 2:#371
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-8000
Mailing Address - Country:US
Mailing Address - Phone:786-606-7516
Mailing Address - Fax:
Practice Address - Street 1:7969 NW 2ND ST
Practice Address - Street 2:#371
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-8000
Practice Address - Country:US
Practice Address - Phone:786-606-7516
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-14
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty