Healthcare Provider Details

I. General information

NPI: 1053426783
Provider Name (Legal Business Name): MIGUEL ARANEO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 08/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4685 S CONGRESS AVE SUITE 200
LAKE WORTH FL
33461-4761
US

IV. Provider business mailing address

3450 LANTANA RD STE 100
LAKE WORTH FL
33462-1304
US

V. Phone/Fax

Practice location:
  • Phone: 561-965-1864
  • Fax: 561-967-5005
Mailing address:
  • Phone: 561-965-1864
  • Fax: 561-967-5005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number20020193
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: