Individual
DR. MIIMII THAE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
381 N KROME AVE STE 112, HOMESTEAD, FL 33030-6047
(305) 246-4774
(305) 248-4086
Mailing address
4236 SW 124TH TER, MIRAMAR, FL 33027-6009
(305) 496-0596
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO4559
FL
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
06/16/2021
Last updated
08/30/2024
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