Healthcare Provider Details

I. General information

NPI: 1205161858
Provider Name (Legal Business Name): MELISSA FIGUEROA MASSANET MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2009
Last Update Date: 08/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11750 SW 40TH STREET
MIAMI FL
33175
US

IV. Provider business mailing address

1613 N. HARRISON PARKWAY SUITE 200 MAILSTOP SH-9A
SUNRISE FL
33323-2896
US

V. Phone/Fax

Practice location:
  • Phone: 305-223-3000
  • Fax: 787-841-7165
Mailing address:
  • Phone: 954-838-2371
  • Fax: 954-851-1746

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number12526I
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME116968
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: