Provider Demographics
NPI:1568942183
Name:RODRIGUEZ GUERRA, MIGUEL ANTONIO (MD)
Entity Type:Individual
Prefix:DR
First Name:MIGUEL
Middle Name:ANTONIO
Last Name:RODRIGUEZ GUERRA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1825 EASTCHESTER RD
Mailing Address - Street 2:DEPT OF MEDICINE
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-2301
Mailing Address - Country:US
Mailing Address - Phone:718-904-2500
Mailing Address - Fax:718-904-2827
Practice Address - Street 1:1825 EASTCHESTER RD
Practice Address - Street 2:DEPT OF MEDICINE
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-2301
Practice Address - Country:US
Practice Address - Phone:718-904-2500
Practice Address - Fax:718-904-2827
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-14
Last Update Date:2022-01-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
NY312368207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program