Healthcare Provider Details

I. General information

NPI: 1386673663
Provider Name (Legal Business Name): ALBERTO INTERIAN JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 09/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3663 S MIAMI AVE
MIAMI FL
33133-4253
US

IV. Provider business mailing address

1500 NW 12TH AVE JMT-EAST 1007
MIAMI FL
33136-1028
US

V. Phone/Fax

Practice location:
  • Phone: 305-854-4400
  • Fax: 305-243-8470
Mailing address:
  • Phone: 305-243-4664
  • Fax: 305-243-8470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME43967
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberME43967
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: