Organization
MAGNOLIA MEDICAL CENTER CORP
Active
Organization
MAGNOLIA MEDICAL CENTER CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIGUEL ANGEL RIESTRA ROSA (OWNER)
(656) 247-0009
Entity
Organization
Contact information
Practice address
160 NW 176TH ST STE 309, MIAMI GARDENS, FL 33169-5048
(305) 488-4550
(786) 219-3881
Mailing address
160 NW 176TH ST STE 309, MIAMI GARDENS, FL 33169-5048
(305) 488-4550
(786) 219-3881
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
08/28/2023
Last updated
07/31/2025
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