Provider Demographics
NPI:1710047121
Name:MURCIANO, ALFREDO IVAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ALFREDO
Middle Name:IVAN
Last Name:MURCIANO
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 1:330 CASUARINA CONCOURSE
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33143-6508
Mailing Address - Country:US
Mailing Address - Phone:305-205-8572
Mailing Address - Fax:
Practice Address - Street 1:330 CASUARINA CONCOURSE
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33143-6508
Practice Address - Country:US
Practice Address - Phone:305-205-8572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME546132080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL063243100Medicaid