Provider Demographics
NPI:1336708478
Name:RODRIGUEZ, RAMIRO (MD)
Entity Type:Individual
Prefix:
First Name:RAMIRO
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:RAMIRO
Other - Middle Name:
Other - Last Name:RODRIGUEZ GONZALEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:214 NW 72ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-4327
Mailing Address - Country:US
Mailing Address - Phone:786-603-3828
Mailing Address - Fax:786-289-0387
Practice Address - Street 1:290 NE 8TH ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-4710
Practice Address - Country:US
Practice Address - Phone:305-423-4044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-12
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN1216208D00000X
PR14919-I208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice