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Individual

MIGUEL M LIBERA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
11801 SW 90TH ST STE 201, MIAMI, FL 33186-2182
(305) 595-1317
Mailing address
6750 SW 156TH CT, MIAMI, FL 33193-2125
(786) 303-0985

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PAT9109707
FL
363AS0400X
Surgical Physician Assistant
Primary
PAT9109707
FL

Other

Enumeration date
08/26/2016
Last updated
08/26/2016
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