Provider Demographics
NPI:1033172978
Name:VIAMONTE, MANUEL III (MD)
Entity Type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:
Last Name:VIAMONTE
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:900 BRICKELL KEY BLVD APT 1604
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-3743
Mailing Address - Country:US
Mailing Address - Phone:305-901-8015
Mailing Address - Fax:305-661-1455
Practice Address - Street 1:4306 ALTON RD FL 3
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2840
Practice Address - Country:US
Practice Address - Phone:305-674-2177
Practice Address - Fax:305-674-2176
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-11
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME55040208600000X, 208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL039184100Medicaid
FL039184100Medicaid
FLK5790Medicare ID - Type Unspecified