MEDICARE: MEDICAL MANAGEMENT OF MIAMI INC.

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	208D00000X	General Practice Physician	ME33469	FL

General Provider Information

NPI Number	:	1497827737
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL MANAGEMENT OF MIAMI INC.

Provider Business Mailing Address
First Line	:	2121 SW 27TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33145-3415
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2121 SW 27TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33145-3415
Country	:	US
Telephone Number	:	305-856-1777
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. LUIS A VELAR
Credential	:	MD
Telephone Number	:	305-856-1777

Provider Enumeration Date	:	11/14/2006
Last Update Date	:	08/22/2020

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