Provider Demographics
NPI:1427413608
Name:MIGUEL RODRIGUEZ-GONZALEZ, M.D., P.A.
Entity Type:Organization
Organization Name:MIGUEL RODRIGUEZ-GONZALEZ, M.D., P.A.
Other - Org Name:CARDIOLOGY SPECIALISTS OF CENTRAL FLORIDA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ-GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-972-9032
Mailing Address - Street 1:1906 OLD CLUB PT
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-4969
Mailing Address - Country:US
Mailing Address - Phone:321-972-9032
Mailing Address - Fax:
Practice Address - Street 1:1906 OLD CLUB PT
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4969
Practice Address - Country:US
Practice Address - Phone:321-972-9032
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-15
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME100897261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty