Individual
DR. RODRIGO A BOLANOS
Active
Individual
DR. RODRIGO A BOLANOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
ME121741
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013541400
—
FL
01
—
143NK
BC/BS NC PROVIDER #
—
01
—
1962504456
MEDCOST PROVIDER #
—
05
—
5909815
—
NC
01
—
N0022E
SOUTH CAROLINA MEDICAID
SC
01
—
P00665200
RAILROAD MEDICARE PROV#
—
Enumeration date
09/04/2006
Last updated
09/06/2024
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