Provider Demographics
NPI:1790524908
Name:BUIGAS, RODOLFO ALBERTO JR (PHD)
Entity type:Individual
Prefix:DR
First Name:RODOLFO
Middle Name:ALBERTO
Last Name:BUIGAS
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 S DIXIE HWY STE 104
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-2455
Mailing Address - Country:US
Mailing Address - Phone:305-586-8372
Mailing Address - Fax:
Practice Address - Street 1:2000 S DIXIE HWY STE 104
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-2455
Practice Address - Country:US
Practice Address - Phone:305-586-8372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT048.0134268103G00000X
FL5986103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist