Organization
ANSELMO H. HUMARAN MD,PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANSELMO HUMARAN MD (PRESIDENT)
(305) 232-2066
Entity
Organization
Contact information
Practice address
11474 QUAIL ROOST DR, MIAMI, FL 33157-6575
(305) 232-2066
Mailing address
11474 QUAIL ROOST DR, MIAMI, FL 33157-6575
(305) 232-2066
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ME41680
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
96178
MEDICARE ID
FL
Enumeration date
11/29/2010
Last updated
09/04/2012
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