Healthcare Provider Details

I. General information

NPI: 1811159650
Provider Name (Legal Business Name): ALEJANDRO LUIS MIQUEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2008
Last Update Date: 03/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 S BARFIELD HWY
PAHOKEE FL
33476-1868
US

IV. Provider business mailing address

5827 CORPORATE WAY
WEST PALM BEACH FL
33407-2000
US

V. Phone/Fax

Practice location:
  • Phone: 561-924-6100
  • Fax: 844-543-0393
Mailing address:
  • Phone: 561-844-9443
  • Fax: 561-472-9692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberBP10030674
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME 112012
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: