MEDICARE: MEN'S ONLY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QA0505X	Adult Medicine Physician

General Provider Information

NPI Number	:	1265265086
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEN'S ONLY, LLC

Provider Business Mailing Address
First Line	:	625 N FLAGLER DR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-4027
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	625 N FLAGLER DR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-4027
Country	:	US
Telephone Number	:	561-870-7254
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ALEJANDRO LUIS MIQUEL
Credential	:	MD
Telephone Number	:	561-870-7254

Provider Enumeration Date	:	08/26/2024
Last Update Date	:	08/26/2024

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