Provider Demographics
NPI:1346400231
Name:MIGUEL, IHOSVANI (MD)
Entity Type:Individual
Prefix:
First Name:IHOSVANI
Middle Name:
Last Name:MIGUEL
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 1:1400 S ANDREWS AVE
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-1840
Mailing Address - Country:US
Mailing Address - Phone:855-844-1545
Mailing Address - Fax:855-844-1545
Practice Address - Street 1:1777 S ANDREWS AVE STE 201
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-2517
Practice Address - Country:US
Practice Address - Phone:855-844-1545
Practice Address - Fax:855-844-1545
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-13
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME106209207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism