Provider Demographics
NPI:1578509642
Name:PENA, RIGOBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:RIGOBERTO
Middle Name:
Last Name:PENA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1551 SAWGRS CORP PKWY
Mailing Address - Street 2:STE 110
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2828
Mailing Address - Country:US
Mailing Address - Phone:954-835-0750
Mailing Address - Fax:954-835-0760
Practice Address - Street 1:1551 SAWGRS CORP PKWY
Practice Address - Street 2:STE 110
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-2828
Practice Address - Country:US
Practice Address - Phone:954-835-0750
Practice Address - Fax:954-835-0760
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93488207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine