Healthcare Provider Details

I. General information

NPI: 1861634974
Provider Name (Legal Business Name): MANUEL V FEIJOO MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2009
Last Update Date: 04/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8370 SW 8TH ST
MIAMI FL
33144-4180
US

IV. Provider business mailing address

8370 SW 8TH ST
MIAMI FL
33144-4180
US

V. Phone/Fax

Practice location:
  • Phone: 305-265-7505
  • Fax: 305-265-7535
Mailing address:
  • Phone: 305-265-7505
  • Fax: 305-265-7535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberME63009
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME63009
License Number StateFL

VIII. Authorized Official

Name: DR. MANUEL VALENTIN FEIJOO
Title or Position: M.D/PRESIDENT
Credential: M.D
Phone: 305-265-7505