Organization
ALL LEVEL GENERAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISSETT M RODRIGUEZ AGUILERA (OWNER)
(786) 542-5056
Entity
Organization
Contact information
Practice address
2100 W 76TH ST STE 408, HIALEAH, FL 33016-5504
(786) 542-5056
Mailing address
2100 W 76TH ST STE 408, HIALEAH, FL 33016-5504
(786) 542-5056
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
06/16/2025
Last updated
06/16/2025
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