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NPI Code Detail

MEDICARE: MIGUEL ANGEL PENA BA

MEDICARE: MIGUEL ANGEL PENA BA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator592564198FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164689022
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIGUEL ANGEL PENA BA
Provider Business Mailing Address
First Line : 3510 BISCAYNE BLVD STE 300
Second Line :
City : MIAMI
State : FL
Zip : 33137-3840
Country : US
Telephone Number : 305-576-1234
Fax Number : 305-571-2020
Provider Business Practice Location Address
First Line : 3510 BISCAYNE BLVD STE 300
Second Line :
City : MIAMI
State : FL
Zip : 33137-3840
Country : US
Telephone Number : 305-576-1234
Fax Number : 305-571-2020
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2008
Last Update Date : 05/19/2008

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Directions to “ MIGUEL ANGEL PENA BA” Practice Location

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