Organization
MIIMII THAE DPM, P.A
Active
Other names
Miimii Thae, MTHAE.INC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIIMII THAE DPM (PRESIDENT /OWNER)
(305) 496-0596
Entity
Organization
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
261QP1100X
Podiatric Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PO4559
PODIATRIC PHYSICIAN LICENSE
FL
Enumeration date
07/01/2024
Last updated
08/30/2024
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