Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | ME97447 | FL |
NPI | 1023234507 |
---|---|
Provider Name | Juan A Bereao |
First Address | Miami, FL 33265-0942 |
Second Address | Miami, FL 33144-4180 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2007 |
Last Update Date | 15/10/2009 |