Provider Demographics
NPI:1871995746
Name:MIKI & ALFONSO HAND & UPPER
Entity type:Organization
Organization Name:MIKI & ALFONSO HAND & UPPER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERTO
Authorized Official - Middle Name:AUGUSTO
Authorized Official - Last Name:MIKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-333-7367
Mailing Address - Street 1:PO BOX 566262
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33256-6262
Mailing Address - Country:US
Mailing Address - Phone:305-333-7367
Mailing Address - Fax:
Practice Address - Street 1:9765 SW 184TH ST
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-6932
Practice Address - Country:US
Practice Address - Phone:305-308-0210
Practice Address - Fax:305-273-2176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-22
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME98778207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIA452BMedicare PIN