MEDICARE: MIGUEL ATILLO ESPIRITU M.D.

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
1	207W00000X	Ophthalmology Physician	ME0028374	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	180006811	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	47040	OTHER	FL	BCBS OF FLORIDA
4	ME0028374	OTHER	FL	MEDICAL LICENSE NUMBER

General Provider Information

NPI Number	:	1639281025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIGUEL ATILLO ESPIRITU M.D.

Provider Business Mailing Address
First Line	:	304 NE 19TH DR
Second Line	:
City	:	OKEECHOBEE
State	:	FL
Zip	:	34972-1911
Country	:	US
Telephone Number	:	863-467-0533
Fax Number	:	863-467-4303

Provider Business Practice Location Address
First Line	:	304 NE 19TH DR
Second Line	:
City	:	OKEECHOBEE
State	:	FL
Zip	:	34972-1911
Country	:	US
Telephone Number	:	863-467-0533
Fax Number	:	863-467-4303

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/06/2012

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Directions to “ MIGUEL ATILLO ESPIRITU M.D.” Practice Location

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