Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207W00000X | Ophthalmologist | 062187 | GA |
N | 207W00000X | Ophthalmologist | 249662 | NY |
N | 207W00000X | Ophthalmologist | M9848 | TX |
Y | 207W00000X | Ophthalmologist | ME 105283 | FL |
N | 208000000X | Pediatrician | 062187 | GA |
N | 208000000X | Pediatrician | 249662 | NY |
N | 208000000X | Pediatrician | M9848 | TX |
N | 208000000X | Pediatrician | ME 105283 | FL |
NPI | 1033372073 |
---|---|
Provider Name | Rodrigo Belalcazar Ardila |
First Address | Miramar, FL 33027-4444 |
Second Address | Miramar, FL 33027-4444 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2008 |
Last Update Date | 11/02/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001466700 | (05) | FL |