Healthcare Provider Details

I. General information

NPI: 1134294689
Provider Name (Legal Business Name): ANTONIO J MURTINHO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 12/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 SW 73RD ST BOX 69
SOUTH MIAMI FL
33143-4679
US

IV. Provider business mailing address

6200 SW 73RD ST BOX 69
SOUTH MIAMI FL
33143-4679
US

V. Phone/Fax

Practice location:
  • Phone: 786-662-5465
  • Fax: 783-662-5334
Mailing address:
  • Phone: 786-662-5465
  • Fax: 783-662-5334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberM886411
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: