Provider Demographics
NPI:1841373453
Name:DRL MEDICAL
Entity type:Organization
Organization Name:DRL MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROCHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-512-3234
Mailing Address - Street 1:551 W 51ST PL
Mailing Address - Street 2:SUITE 204
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3601
Mailing Address - Country:US
Mailing Address - Phone:305-512-3234
Mailing Address - Fax:305-512-3234
Practice Address - Street 1:551 W 51 PLACE
Practice Address - Street 2:SUITE 204
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3601
Practice Address - Country:US
Practice Address - Phone:305-512-3234
Practice Address - Fax:305-512-3234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK8588Medicare ID - Type UnspecifiedPROVIDER NUMBER