Provider Demographics
NPI:1255653820
Name:BEGUIRISTAIN, ALBERTO JAVIER (FIRST ASSISTANT)
Entity Type:Individual
Prefix:
First Name:ALBERTO
Middle Name:JAVIER
Last Name:BEGUIRISTAIN
Suffix:
Gender:M
Credentials:FIRST ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6101 SW 72ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-1864
Mailing Address - Country:US
Mailing Address - Phone:305-661-5001
Mailing Address - Fax:
Practice Address - Street 1:6101 SW 72ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-1864
Practice Address - Country:US
Practice Address - Phone:305-661-5001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-23
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHSE128363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical