Provider Demographics
NPI:1609853464
Name:MERCHAN, JAIME R (MD)
Entity Type:Individual
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First Name:JAIME
Middle Name:R
Last Name:MERCHAN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1475 NW 12TH AVE
Mailing Address - Street 2:SUITE 3300
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1002
Mailing Address - Country:US
Mailing Address - Phone:305-243-1287
Mailing Address - Fax:305-243-1293
Practice Address - Street 1:1475 NW 12TH AVE
Practice Address - Street 2:SUITE 3300
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1002
Practice Address - Country:US
Practice Address - Phone:305-243-1287
Practice Address - Fax:305-243-1293
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2013-01-31
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Provider Licenses
StateLicense IDTaxonomies
FLME74584207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN036681100Medicaid
MN036681100Medicaid