Basic Information
| Provider Information | |||||||||
| NPI: | 1609023670 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HECTOR S RODRIGUEZ MEDICAL GROUP INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4011 WEST FLAGLER ST | ||||||||
| Address2: | SUITE204 | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331341643 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3057741234 | ||||||||
| FaxNumber: | 3057741639 | ||||||||
| Practice Location | |||||||||
| Address1: | 4011 WEST FLAGLER ST | ||||||||
| Address2: | SUITE 204 | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331342616 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3057741234 | ||||||||
| FaxNumber: | 3057741639 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/21/2008 | ||||||||
| LastUpdateDate: | 12/12/2017 | ||||||||
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| AuthorizedOfficialLastName: | RODRIGUEZ | ||||||||
| AuthorizedOfficialFirstName: | HECTOR | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3057741234 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | ME66905 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.