Rodolfo G Miro MD PA

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

ME16261 Issued in FL

Legal business name

RODOLFO G MIRO MD PA

Practice address

2108 Lakeland Hills Blvd
Lakeland, FL 33805-2906

Phone

(863) 683-7561

Fax

(863) 682-2423

NPI assigned

Nov 8, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Diane Jordan

Title

Secretary

Phone

(863) 683-7561

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1289174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291248000000",
    "number": "1285935213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338052906",
            "telephone_number": "863-683-7561",
            "fax_number": "863-682-2423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2108 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338052906",
            "telephone_number": "863-683-7561",
            "fax_number": "863-682-2423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RODOLFO G MIRO MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-08",
        "last_updated": "2010-12-02",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "863-683-7561"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME16261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID NUMBER",
            "identifier": "53385",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jezaray Rodden, OTD
• Joseph D Roderique, M.D.
• Glenda Rodgers
• Rodolfo Dumenigo MD PA (Clinical Care Medical Centers)
• Rodolfo Dumenigo MD PA (Clinical Care Medical Centers)
• Eylee Rodriguez Acosta
• Edwin O. Rodriguez Cintron, CRNA
• Andrea Rodriguez Jimenez
• Alexis Rodriguez Mercado, MD
• Juan Oscar Rodriguez Padilla, MD

• Gastroenterology Physician in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Gastroenterology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.