Provider Demographics
NPI:1770500860
Name:RODOLFO GUTIERREZ-ALSINA MD PA
Entity Type:Organization
Organization Name:RODOLFO GUTIERREZ-ALSINA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RODOLFO
Authorized Official - Middle Name:
Authorized Official - Last Name:GUTIERREZ-ALSINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-325-8587
Mailing Address - Street 1:2387 W 68TH ST STE 401
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-6890
Mailing Address - Country:US
Mailing Address - Phone:305-325-8587
Mailing Address - Fax:305-325-8589
Practice Address - Street 1:2387 W 68TH ST STE 401
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-6890
Practice Address - Country:US
Practice Address - Phone:305-325-8587
Practice Address - Fax:305-325-8589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME51217207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK4306OtherMEDICARE PTAN
FLDB8102OtherRAILFORD MEDICARE