Provider Demographics
NPI:1285096669
Name:MIR REMEDIOS, ARIEL J SR (MD)
Entity type:Individual
Prefix:DR
First Name:ARIEL
Middle Name:J
Last Name:MIR REMEDIOS
Suffix:SR
Gender:M
Credentials:MD
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Mailing Address - Street 1:5190 NW 167TH ST STE 109
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-6329
Mailing Address - Country:US
Mailing Address - Phone:305-384-6450
Mailing Address - Fax:305-384-6456
Practice Address - Street 1:5190 NW 167TH ST STE 109
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014
Practice Address - Country:US
Practice Address - Phone:305-384-6450
Practice Address - Fax:305-384-6456
Is Sole Proprietor?:No
Enumeration Date:2016-03-24
Last Update Date:2018-07-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR19280208D00000X
FLACN859208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice