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Individual

DR. PHILIP C. MIRMELLI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
400 ARTHUR GODFREY RD, SUITE 504, MIAMI BEACH, FL 33140-3516
(305) 538-8339
(305) 538-4907
Mailing address
11880 SW 40TH ST, SUITE 304, MIAMI, FL 33175-3584
(305) 223-8808
(305) 223-8974

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
ME25815
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
375593200
FL
01
78527N
MEDICARE
FL
01
78527Y
MEDICARE
FL
Enumeration date
04/11/2006
Last updated
09/21/2015
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