MEDICARE: DR. MIRIAM A FELIZ 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	208100000X	Physical Medicine & Rehabilitation Physician	ME43362	FL
2	174400000X	Specialist	ME0043362	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558320887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MIRIAM A FELIZ M.D.

Provider Business Mailing Address
First Line	:	3487 NW 30TH ST
Second Line	:
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33311-1103
Country	:	US
Telephone Number	:	954-641-4200
Fax Number	:	954-487-1807

Provider Business Practice Location Address
First Line	:	8850 NW 122ND ST
Second Line	:
City	:	HIALEAH GARDENS
State	:	FL
Zip	:	33018
Country	:	US
Telephone Number	:	954-641-4200
Fax Number	:	954-487-1807

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

Provider Enumeration Date	:	03/23/2006
Last Update Date	:	03/23/2021

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