Provider Demographics
NPI:1124288402
Name:MANUEL RODRIGUEZ GARCIA MD PA
Entity type:Organization
Organization Name:MANUEL RODRIGUEZ GARCIA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ-GARCIA MD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-666-8300
Mailing Address - Street 1:7550 SW 57 AVE
Mailing Address - Street 2:SUITE 208
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5543
Mailing Address - Country:US
Mailing Address - Phone:305-666-8300
Mailing Address - Fax:305-662-2004
Practice Address - Street 1:7550 SW 57 AVE
Practice Address - Street 2:SUITE 208
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5543
Practice Address - Country:US
Practice Address - Phone:305-666-8300
Practice Address - Fax:305-662-2004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-11
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00408082084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty