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General NPI Number Information
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NPI Number | 1952414229
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Entity Type | Individual
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Provider Name | JUAN A PUERTO MD PA
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Gender | Male
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 07/26/2010
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Provider Practice Location Address
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Address Line | 10661 N KENDALL DR SUITE 109
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City | MIAMI
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State | FL
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Zip | 33176
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Country | US
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Telephone | 305-273-9923
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Fax | 305-273-8825
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Provider Business Mailing Address
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Address Line | PO BOX 160463
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City | MIAMI
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State | FL
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Zip | 33116-0463
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Country | US
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Telephone | 305-273-9923
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Fax | 305-273-8825
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | ME0036313
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License Number State | FL
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