Provider Demographics
NPI:1912914698
Name:CHAMAH-FARRE, MIGUEL A (MD)
Entity Type:Individual
Prefix:DR
First Name:MIGUEL
Middle Name:A
Last Name:CHAMAH-FARRE
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 1:1800 W 68TH ST
Mailing Address - Street 2:SUITE 127
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33014-4404
Mailing Address - Country:US
Mailing Address - Phone:305-820-0903
Mailing Address - Fax:305-826-3827
Practice Address - Street 1:1800 W 68TH ST
Practice Address - Street 2:SUITE 127
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-4404
Practice Address - Country:US
Practice Address - Phone:305-820-0903
Practice Address - Fax:305-826-3827
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME63363208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL372121300Medicaid
FL18481Medicare ID - Type Unspecified
F51597Medicare UPIN