Provider Demographics
NPI:1053327577
Name:MIGUEL A CHAMAH MD PA
Entity type:Organization
Organization Name:MIGUEL A CHAMAH MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHAMAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-820-0903
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME63363208D00000X
FLPA9100815363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Not Answered363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK4246Medicare ID - Type Unspecified