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Individual

ROQUE MIRAMONTES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA, MPH

Contact information

Practice address
1600 CLIFTON RD NE, MS: E-10, ATLANTA, GA 30329-4018
(404) 639-6306
(404) 929-2854
Mailing address
1600 CLIFTON RD NE, MS: E-10, ATLANTA, GA 30329-4018
(404) 639-6306
(404) 929-2854

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
005548
GA
363A00000X
Physician Assistant
PA10004457
WA
363A00000X
Physician Assistant
PA16051
CA

Other

Enumeration date
06/12/2009
Last updated
06/12/2009
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