Individual
MICHAEL A REBOLLEDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
848 ADAMS AVE, L400, MEMPHIS, TN 38103-2816
(901) 287-7337
(901) 287-4646
Mailing address
51 N DUNLAP ST, G145, MEMPHIS, TN 38105-4625
(901) 287-5594
(901) 287-6804
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
54187
TN
2080P0202X
Pediatric Cardiology Physician
A52896
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A528960
—
CA
Enumeration date
09/20/2006
Last updated
03/18/2016
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