Provider Demographics
NPI:1851500961
Name:CAVALLAZZI, RODRIGO SILVA (MD)
Entity Type:Individual
Prefix:DR
First Name:RODRIGO
Middle Name:SILVA
Last Name:CAVALLAZZI
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Gender:M
Credentials:MD
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Mailing Address - Street 1:501 E BROADWAY
Mailing Address - Street 2:STE 290
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-2040
Mailing Address - Country:US
Mailing Address - Phone:502-217-8347
Mailing Address - Fax:502-217-5056
Practice Address - Street 1:401 E CHESTNUT STREET, #310
Practice Address - Street 2:UNIVERSITY MEDICAL ASSOCIATES
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-5703
Practice Address - Country:US
Practice Address - Phone:502-589-6788
Practice Address - Fax:502-584-8563
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2020-01-23
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Provider Licenses
StateLicense IDTaxonomies
KY43532207RC0200X, 207RP1001X
KYTP125390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100129840Medicaid
KY7100129840Medicaid