MEDICARE: ROBERTO ANDRES PIRE SUPPORT COORDINATOR

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	171M00000X	Case Manager/Care Coordinator	691667801	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	:	1902247026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERTO ANDRES PIRE SUPPORT COORDINATOR

Provider Business Mailing Address
First Line	:	6267 W 24TH AVE
Second Line	:	APT 104
City	:	HIALEAH
State	:	FL
Zip	:	33016-6956
Country	:	US
Telephone Number	:	305-351-6133
Fax Number	:

Provider Business Practice Location Address
First Line	:	6267 W 24TH AVE
Second Line	:	APT 104
City	:	HIALEAH
State	:	FL
Zip	:	33016-6956
Country	:	US
Telephone Number	:	305-351-6133
Fax Number	:

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

Provider Enumeration Date	:	07/17/2013
Last Update Date	:	07/17/2013

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