Organization
FAMILY MEDICAL GROUP - HML
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIZSANDRA RODRIGUEZ (OWNER)
(786) 399-7390
Entity
Organization
Contact information
Practice address
7100 W 20TH AVE STE 616, HIALEAH, FL 33016-1814
(305) 435-4465
(359) 902-2506
Mailing address
7100 W 20TH AVE STE 616, HIALEAH, FL 33016-1814
(305) 435-4465
(359) 902-2506
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
JG446A
MEDICARE
FL
Enumeration date
09/27/2022
Last updated
09/29/2022
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