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NPI Code Detail

MEDICARE: ANA M ELOSEGUI M.D.

MEDICARE: ANA M ELOSEGUI 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
1207Q00000XFamily Medicine PhysicianME 85963FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ME 85963OTHERFLLICENSE

General Provider Information

NPI Number : 1447221130
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANA M ELOSEGUI M.D.
Provider Business Mailing Address
First Line : 85 GRAND CANAL DRIVE
Second Line : SUITE 310
City : MIAMI
State : FL
Zip : 33144-2570
Country : US
Telephone Number : 305-261-5454
Fax Number : 305-261-5455
Provider Business Practice Location Address
First Line : 85 GRAND CANAL DRIVE
Second Line : SUITE 310
City : MIAMI
State : FL
Zip : 33144-2570
Country : US
Telephone Number : 305-261-5454
Fax Number : 305-261-5455
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2006
Last Update Date : 07/28/2014

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