1316995129

Everything you always wanted to know about DR. MADARIAGA G MIGUEL MD but were afraid to ask.

DR. MADARIAGA G MIGUEL MD

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Provider Prefix Provider Last Name Provider Middle Name Provider First Name Provider Credential
DR. MADARIAGA G MIGUEL MD
Gender:
Male
Enumeration date:
2006-05-04
Last update date:
2017-06-23
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
Yes
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Identifiers

identifier description issuer state
14R2G Other BCBS FL
HK072Z Other MEDICARE FL
009636600 Medicaid none FL

Taxonomies

Taxonomy State License Number Primary?
207RI0200X Infectious Disease FL ME116589 Y

Phone Numbers

Type Number
Mailing Address Fax Number 2396439062
Practice Location Address Fax Number 2396439062
Mailing Address Telephone Number (239) 624-0800
Practice Location Address Telephone Number (239) 624-0800

Addresses

Type Address City State Postal Country
Mailing Address 800 GOODLETTE RD N STE 370 NAPLES FL 34102 FL
Practice Location Address 800 GOODLETTE RD N STE 370 NAPLES FL 34102 FL

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1760449854 BOCHORISHVILI, VAKHTANG
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