MEDICARE: DR. JOSE LUIS PUMARINO 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	2080P0202X	Pediatric Cardiology Physician	ME83494	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1710998026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSE LUIS PUMARINO M.D.

Provider Business Mailing Address
First Line	:	1500 CONCORD TER
Second Line	:
City	:	SUNRISE
State	:	FL
Zip	:	33323-2815
Country	:	US
Telephone Number	:	800-243-3839
Fax Number	:	954-858-0404

Provider Business Practice Location Address
First Line	:	3659 SOUTH MIAMI AVE
Second Line	:	3002
City	:	MIAMI
State	:	FL
Zip	:	33133
Country	:	US
Telephone Number	:	305-858-7940
Fax Number	:	305-858-2361

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

Provider Enumeration Date	:	08/11/2006
Last Update Date	:	06/11/2014

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