Healthcare Provider Details

I. General information

NPI: 1497710941
Provider Name (Legal Business Name): MIKKAEL A. SEKERES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 02/06/2025
Certification Date: 02/06/2025
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: 305-243-6302
  • Fax: 305-243-9161
Mailing address:
  • Phone: 305-243-6302
  • Fax: 305-243-9161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberME147471
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: