Provider Demographics
NPI:1457864753
Name:PARRILLA MD LLC
Entity Type:Organization
Organization Name:PARRILLA MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:JL
Authorized Official - Last Name:PARRILLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-696-0842
Mailing Address - Street 1:1025 E 25TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-3703
Mailing Address - Country:US
Mailing Address - Phone:305-696-0842
Mailing Address - Fax:305-696-2150
Practice Address - Street 1:1025 E 25TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-3703
Practice Address - Country:US
Practice Address - Phone:305-696-0842
Practice Address - Fax:305-696-2150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-08
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME130156208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY136147669OtherDRIVERS LICENSE