Provider Demographics
NPI:1215987821
Name:CHAMORRO, EMILIANO J (MD)
Entity type:Individual
Prefix:DR
First Name:EMILIANO
Middle Name:J
Last Name:CHAMORRO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6101 BLUE LAGOON DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3168
Mailing Address - Country:US
Mailing Address - Phone:305-500-2000
Mailing Address - Fax:
Practice Address - Street 1:692 NORTH HOMESTEAD BOULAVARD
Practice Address - Street 2:STE 102
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030
Practice Address - Country:US
Practice Address - Phone:305-631-0660
Practice Address - Fax:305-631-1362
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2023-03-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME91087207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME91087OtherMEDICAL LICENSE