Provider Demographics
NPI:1316436272
Name:MENENDEZ, MIGUEL JAVIER (MD)
Entity type:Individual
Prefix:DR
First Name:MIGUEL
Middle Name:JAVIER
Last Name:MENENDEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 NW 79TH AVE
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33122-1174
Mailing Address - Country:US
Mailing Address - Phone:786-466-1000
Mailing Address - Fax:321-843-5177
Practice Address - Street 1:5521 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2219
Practice Address - Country:US
Practice Address - Phone:305-685-5688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-07
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR021873207R00000X
PR21873208M00000X
FLME145725207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist