Provider Demographics
NPI:1659434207
Name:CATTAN, ROGELIO (MD)
Entity Type:Individual
Prefix:
First Name:ROGELIO
Middle Name:
Last Name:CATTAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ROGELIO
Other - Middle Name:ALEXIS
Other - Last Name:CATTAN ALVAREZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:19800 SW 190TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33187-1818
Mailing Address - Country:US
Mailing Address - Phone:305-971-5229
Mailing Address - Fax:305-383-8338
Practice Address - Street 1:19800 SW 190TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33187-1818
Practice Address - Country:US
Practice Address - Phone:305-971-5229
Practice Address - Fax:305-383-8338
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 47936207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL08235Medicare ID - Type Unspecified
FLE22222Medicare UPIN