Organization
BLUE MEDICI CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUIS HERNANDEZ ROSADO MD (OWNER)
(787) 902-2594
Entity
Organization
Contact information
Practice address
12780 SW 71ST AVE, PINECREST, FL 33156-6239
(787) 902-2594
(305) 470-1853
Mailing address
12780 SW 71ST AVE, PINECREST, FL 33156-6239
(787) 902-2594
(305) 470-1853
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1144527466
INDIVIDUAL NPI
FL
Enumeration date
10/26/2022
Last updated
11/01/2022
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