Provider Demographics
NPI:1346290863
Name:ALTAMIRANO, JAIME AUGUSTO (MD)
Entity Type:Individual
Prefix:DR
First Name:JAIME
Middle Name:AUGUSTO
Last Name:ALTAMIRANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:P.O. BOX 566210
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33256-6210
Mailing Address - Country:US
Mailing Address - Phone:305-227-1733
Mailing Address - Fax:305-227-3151
Practice Address - Street 1:11760 SW 40TH ST
Practice Address - Street 2:SUITE 335
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3595
Practice Address - Country:US
Practice Address - Phone:305-227-1733
Practice Address - Fax:305-227-3151
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2018-02-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME45612207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2609258-00Medicaid
FL2609258-00Medicaid
FL10661Medicare PIN