Individual ProviderRene ParragaInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address1611 NW 12th Ave, Miami, FL 33136-1005(305) 585-5215(305) 243-4666PECOS EnrollmentBased on the most recent information from CMS, provider Rene Parraga is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1316148919Provider TypeIndividualFull NameParraga, ReneCredentialM.D.GenderMaleSole ProprietorNoEnumeration Date5/30/2007Last Updated3/25/2009Contact InformationPractice LocationPractice Address1611 NW 12th Ave, Miami, FL 33136-1005Phone(305) 585-5215FaxUnlisted FaxMailing LocationMailing Address1500 NW 12th Ave Jmt-East 1007, Miami, FL 33136-1028Phone(305) 243-4666Fax(305) 243-9927Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense102150FloridaCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseTRN9131FloridaProvider IdentifiersIDDescriptionIssuerID0004540-00DescriptionMedicaidIssuerUnlistedFlorida