Provider Demographics
NPI:1871571471
Name:ALTAMIRANO, DARIO D (DO)
Entity type:Individual
Prefix:
First Name:DARIO
Middle Name:D
Last Name:ALTAMIRANO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 W 49TH ST STE 440
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3487
Mailing Address - Country:US
Mailing Address - Phone:305-820-1944
Mailing Address - Fax:
Practice Address - Street 1:900 W 49TH ST
Practice Address - Street 2:SUITE # 440
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3402
Practice Address - Country:US
Practice Address - Phone:305-820-1944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-04
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8448207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL261803600Medicaid
FL01131YMedicare ID - Type UnspecifiedDADE
FL01131WMedicare PIN
FL01131ZMedicare ID - Type UnspecifiedBROWARD
FL261803600Medicaid