Provider Demographics
NPI:1144355512
Name:CARLOS RODRIGUEZ-MURGUIA MD PA
Entity type:Organization
Organization Name:CARLOS RODRIGUEZ-MURGUIA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-863-9696
Mailing Address - Street 1:180 HIALEAH DR
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-5250
Mailing Address - Country:US
Mailing Address - Phone:305-863-9696
Mailing Address - Fax:305-805-8001
Practice Address - Street 1:180 HIALEAH DR
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-5250
Practice Address - Country:US
Practice Address - Phone:305-863-9696
Practice Address - Fax:305-805-8001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0044864261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL069940300Medicaid
FL069940300Medicaid
FL96585Medicare UPIN