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General NPI Number Information
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NPI Number | 1306992235
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Entity Type | Individual
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Provider Name | MIGUEL LIVERA C.S.A.
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Gender | Male
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 08/14/2008
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Provider Practice Location Address
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Address Line | 4300 ALTON RD
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City | MIAMI BEACH
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State | FL
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Zip | 33140-2800
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Country | US
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Telephone | 305-674-2720
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Fax | 305-674-2723
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Provider Business Mailing Address
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Address Line | 6050 NW 194TH TER
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City | HIALEAH
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State | FL
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Zip | 33015-4809
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Country | US
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Telephone | 786-390-8331
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZS0410X
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Taxonomy Name | Surgical Technologist
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License Number | 00194
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License Number State | FL
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