# MAGNOLIA MEDICAL CENTER CORP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174308365
- **Authorized official:** MIGUEL ANGEL RIESTRA ROSA (OWNER)
- **Authorized official phone:** (656) 247-0009

## Contact information

- **Practice address:** 160 NW 176TH ST STE 309, MIAMI GARDENS, FL 33169-5048
- **Practice address phone:** (305) 488-4550
- **Practice address fax:** (786) 219-3881
- **Mailing address:** 160 NW 176TH ST STE 309, MIAMI GARDENS, FL 33169-5048
- **Mailing address phone:** (305) 488-4550
- **Mailing address fax:** (786) 219-3881

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/28/2023
- **Last updated:** 07/31/2025