Organization
JENNY MEDICAL CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAUL RODRIGUEZ (PRESIDENT/OWNER)
(305) 476-1650
Entity
Organization
Contact information
Practice address
3990 W FLAGLER ST, SUITE 205, CORAL GABLES, FL 33134-1644
(305) 476-1650
(305) 476-1649
Mailing address
3990 W FLAGLER ST, SUITE 205, CORAL GABLES, FL 33134-1644
(305) 476-1650
(305) 476-1649
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
HCC7168
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HCC7168
AHCA LICENSE
FL
Enumeration date
10/02/2006
Last updated
08/22/2020
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