Provider Demographics
NPI:1376545079
Name:MILITANO, ULISES P (MD)
Entity Type:Individual
Prefix:
First Name:ULISES
Middle Name:P
Last Name:MILITANO
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 1:11760 BIRD ROAD
Mailing Address - Street 2:STE 722
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175
Mailing Address - Country:US
Mailing Address - Phone:305-559-1883
Mailing Address - Fax:305-559-1887
Practice Address - Street 1:11760 BIRD ROAD
Practice Address - Street 2:STE 722
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175
Practice Address - Country:US
Practice Address - Phone:305-559-1883
Practice Address - Fax:305-559-1887
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY232110207XX0801X
FLME 88105207XX0801X
FLME88105207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLKY881OtherFL HFMG MEDICARE
FL71928TOtherFL HFMG MEDICAE
FL2680289-00Medicaid
FL104099700Medicaid