Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | ME26739 | FL |
NPI | 1023007119 |
---|---|
Provider Name | Dr. Rolando Cesar Mendizabal |
First Address | Miami, FL 33125-1610 |
Second Address | Miami, FL 33125-1610 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2005 |
Last Update Date | 29/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
035560700 | (05) | FL |
592302851 | CORPORATE TAX ID (01) | FL |
D60106 | (02) | FL |