Organization
MI TIERRA MEDICAL GROUP CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOAN RODRIGUEZ (PRESIDENT)
(786) 238-3054
Entity
Organization
Contact information
Practice address
14201 SW 120TH ST STE 110, MIAMI, FL 33186-7662
(786) 238-7492
(786) 238-7426
Mailing address
14201 SW 120TH ST STE 110, MIAMI, FL 33186-7662
(786) 238-7492
(786) 238-7426
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
251B00000X
Case Management Agency
—
—
261Q00000X
Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
09/17/2021
Last updated
10/02/2025
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