MEDICARE: DR. MARIA ELAINE JOSE M.D.

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	174400000X	Specialist	ME93412	FL

General Provider Information

NPI Number	:	1417162595
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIA ELAINE JOSE M.D.

Provider Business Mailing Address
First Line	:	400 ALTON RD
Second Line	:	UNIT 2308
City	:	MIAMI BEACH
State	:	FL
Zip	:	33139-6702
Country	:	US
Telephone Number	:	202-549-6866
Fax Number	:	305-552-2099

Provider Business Practice Location Address
First Line	:	9250 W FLAGLER ST
Second Line	:	HC GO
City	:	MIAMI
State	:	FL
Zip	:	33174-3414
Country	:	US
Telephone Number	:	305-552-2342
Fax Number	:	305-552-2099

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2007
Last Update Date	:	12/04/2012

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