Healthcare Provider Details

I. General information

NPI: 1306307590
Provider Name (Legal Business Name): MIRIAM AGYAKOMAH OSEI MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MIRIAM AGYAKOMAH KWARTENG-SIAW MD, MPH

II. Dates (important events)

Enumeration Date: 03/29/2019
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1475 NW 12TH AVE
MIAMI FL
33136-1002
US

IV. Provider business mailing address

1475 NW 12TH AVE
MIAMI FL
33136-1002
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-5302
  • Fax:
Mailing address:
  • Phone: 305-243-5302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License NumberME182530
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: