Provider Demographics
NPI:1427141951
Name:AMAT, LUIS FERNANDO (MD)
Entity type:Individual
Prefix:DR
First Name:LUIS
Middle Name:FERNANDO
Last Name:AMAT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:LUIS
Other - Middle Name:FERNANDO
Other - Last Name:AMAT-Y-LEON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2025 BRICKELL AVE
Mailing Address - Street 2:1603
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33129-1743
Mailing Address - Country:US
Mailing Address - Phone:305-854-4234
Mailing Address - Fax:305-854-4234
Practice Address - Street 1:1295 NW 14TH ST
Practice Address - Street 2:N
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-1610
Practice Address - Country:US
Practice Address - Phone:305-325-8990
Practice Address - Fax:305-325-0859
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0040699207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0669855700Medicaid
FL0669855700Medicaid