Provider Demographics
NPI:1891360947
Name:ARTEAGA ABRAHANTES, LUIS MIGUEL (SA-C)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:MIGUEL
Last Name:ARTEAGA ABRAHANTES
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16321 SW 44TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-5326
Mailing Address - Country:US
Mailing Address - Phone:786-420-7632
Mailing Address - Fax:
Practice Address - Street 1:16321 SW 44TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33185-5326
Practice Address - Country:US
Practice Address - Phone:786-420-7632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-21
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21-254246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant