Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | ME44851 | FL |
NPI | 1003162561 |
---|---|
Provider Name | Dr. Miguel Venereo |
First Address | Southwest Ranches, FL 33330-3416 |
Second Address | Southwest Ranches, FL 33330-3416 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2012 |
Last Update Date | 01/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
035100800 | (05) | FL |