Provider Demographics
NPI:1487860714
Name:MIGUEL A AMOR MD PA
Entity Type:Organization
Organization Name:MIGUEL A AMOR MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:AMOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-642-9393
Mailing Address - Street 1:PO BOX 144634
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33114-4634
Mailing Address - Country:US
Mailing Address - Phone:305-642-9393
Mailing Address - Fax:305-642-9996
Practice Address - Street 1:434 SW 12TH AVE
Practice Address - Street 2:SUITE 306
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-2440
Practice Address - Country:US
Practice Address - Phone:305-642-9393
Practice Address - Fax:305-642-9996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME68520208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherEIN NUMBER
FL21123Medicare PIN