Provider Demographics
NPI:1205260221
Name:RODRIGUEZ KALAF, IVAN ROBERTO (MD)
Entity type:Individual
Prefix:
First Name:IVAN
Middle Name:ROBERTO
Last Name:RODRIGUEZ KALAF
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:PO BOX 440728
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-0728
Mailing Address - Country:US
Mailing Address - Phone:305-234-8264
Mailing Address - Fax:305-255-1752
Practice Address - Street 1:12002 SW 128TH CT STE 204
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4643
Practice Address - Country:US
Practice Address - Phone:305-234-8264
Practice Address - Fax:305-255-1752
Is Sole Proprietor?:No
Enumeration Date:2013-08-27
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME128321207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine