Provider Demographics
NPI:1295796613
Name:RODRIGUEZ-GARCIA, MANUEL (MD)
Entity type:Individual
Prefix:MR
First Name:MANUEL
Middle Name:
Last Name:RODRIGUEZ-GARCIA
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 1:7550 SW 57 AVE
Mailing Address - Street 2:SUITE 208
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5543
Mailing Address - Country:US
Mailing Address - Phone:305-666-8300
Mailing Address - Fax:305-662-2004
Practice Address - Street 1:7550 SW 57 AVE
Practice Address - Street 2:SUITE 208
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5543
Practice Address - Country:US
Practice Address - Phone:305-666-8300
Practice Address - Fax:305-662-2004
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00408082084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL062129300Medicaid
FL062129300Medicaid
11373Medicare ID - Type Unspecified