Healthcare Provider Details

I. General information

NPI: 1417259540
Provider Name (Legal Business Name): MICHELINO SCARLATA MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2010
Last Update Date: 12/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 BISCAYNE BLVD SUITE 300
MIAMI FL
33137-9800
US

IV. Provider business mailing address

5161 COLLINS AVE APT 1609
MIAMI BEACH FL
33140-2755
US

V. Phone/Fax

Practice location:
  • Phone: 305-571-0620
  • Fax: 305-576-8099
Mailing address:
  • Phone: 300-586-7191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME104846
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License NumberME104846
License Number StateFL

VIII. Authorized Official

Name: DR. MICHELINO SCARLATA
Title or Position: PRESIDENT
Credential:
Phone: 305-498-6377