Individual ProviderHiram RodriguezInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address1475 NW 12th Ave, Box 016960 M851, Miami, FL 33136-1002(305) 243-7249PECOS EnrollmentBased on the most recent information from CMS, provider Hiram Rodriguez 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 ID1417911173Provider TypeIndividualFull NameRodriguez, HiramCredentialMDGenderMaleSole ProprietorNoEnumeration Date4/12/2006Last Updated1/30/2013Contact InformationPractice LocationPractice Address1475 NW 12th Ave, Box 016960 M851, Miami, FL 33136-1002Phone(305) 243-7249Fax(305) 243-8470Mailing LocationMailing Address1475 NW 12th Ave, Box 016960 M851, Miami, FL 33136-1002Phone(305) 243-7249Fax(305) 243-8470Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseME85278FloridaProvider IdentifiersIDDescriptionIssuerID2649021-00DescriptionMedicaidIssuerUnlistedFlorida