Provider Demographics
NPI:1093736399
Name:ARTEAGA, JUAN F (MD)
Entity Type:Individual
Prefix:MR
First Name:JUAN
Middle Name:F
Last Name:ARTEAGA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10067 PINES BOULEVARD. SUITE A.
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024
Mailing Address - Country:US
Mailing Address - Phone:954-430-6900
Mailing Address - Fax:954-430-6988
Practice Address - Street 1:10067 PINES BOULEVARD. SUITE A.
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024
Practice Address - Country:US
Practice Address - Phone:954-430-6900
Practice Address - Fax:954-430-6988
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0066141207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL375422700Medicaid
FL25518OtherBCBS
FL25518OtherBCBS