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Organization
MIAMI MEDICAL & WELLNESS CENTER LLC
Active
Organization
MIAMI MEDICAL & WELLNESS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RODOLFO DUMENIGO JR. M.D (PRESIDENT)
(305) 534-0076
Entity
Organization
Contact information
Practice address
7500 SW 8TH ST, SUITE 103, MIAMI, FL 33144-4400
(305) 534-0076
(305) 735-6471
Mailing address
1200 ALTON RD, MIAMI BEACH, FL 33139-3810
(305) 534-0076
(305) 907-5442
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
ME58111
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11761Q
MEDICARE PTAN DUMENIGO
FL
01
—
E6931S
MEDICARE PTAN ALONSO
FL
01
—
GK944Y
MEDICARE PTAN DE LEON
FL
01
—
ID353A
MEDICARE PTAN
FL
Enumeration date
09/09/2015
Last updated
09/10/2015
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