Individual
ANSELMO HUMBERTO HUMARAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11474 QUAIL ROOST DR, MIAMI, FL 33157-6575
(305) 232-2066
(305) 232-2089
Mailing address
11474 QUAIL ROOST DR, MIAMI, FL 33157-6575
(305) 232-2066
(305) 232-2089
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ME41680
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
067320000
—
FL
01
—
96178
MEDICARE ID
FL
Enumeration date
08/31/2006
Last updated
10/08/2012
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