Provider Demographics
NPI:1821165333
Name:LUIS F MAGGIOLO MD LLC
Entity Type:Organization
Organization Name:LUIS F MAGGIOLO MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:F
Authorized Official - Last Name:MAGGIOLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-444-2858
Mailing Address - Street 1:9090 SW 87TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2315
Mailing Address - Country:US
Mailing Address - Phone:305-444-2858
Mailing Address - Fax:305-448-3346
Practice Address - Street 1:9090 SW 87TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2315
Practice Address - Country:US
Practice Address - Phone:305-444-2858
Practice Address - Fax:305-448-3346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty