Sergio de Jesus Rodriguez, MD PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME103191 Issued in FL

Legal business name

SERGIO DE JESUS RODRIGUEZ, MD PA

Practice address

2020 NE 163Rd St
Suite # 108
N Miami Beach, FL 33162-4927

Phone

(305) 749-3677

Fax

(305) 749-3685

NPI assigned

Jun 7, 2013

Organization subpart

No

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

Authorized official

Name

Sergio De Jesus Rodriguez, MD

Title

President

Phone

(305) 749-3677

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1370563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370563200000",
    "number": "1699113993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 NE 163RD ST",
            "address_2": "SUITE # 108",
            "city": "N MIAMI BEACH",
            "state": "FL",
            "postal_code": "331624927",
            "telephone_number": "305-749-3677",
            "fax_number": "305-749-3685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 NE 163RD ST",
            "address_2": "SUITE # 108",
            "city": "N MIAMI BEACH",
            "state": "FL",
            "postal_code": "331624927",
            "telephone_number": "305-749-3677",
            "fax_number": "305-749-3685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERGIO DE JESUS RODRIGUEZ, MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-07",
        "last_updated": "2013-06-07",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "SERGIO",
        "authorized_official_middle_name": "DE JESUS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-749-3677",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME103191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in N Miami Beach, FL
• Providers in N Miami Beach, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2013; 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.