Provider Demographics
NPI:1366620809
Name:TIRADOR, MAXIMO RAMON (SA-C)
Entity type:Individual
Prefix:
First Name:MAXIMO
Middle Name:RAMON
Last Name:TIRADOR
Suffix:
Gender:M
Credentials:SA-C
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Mailing Address - Street 1:6440 NW 114TH AVE UNIT 405
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-4572
Mailing Address - Country:US
Mailing Address - Phone:305-905-7628
Mailing Address - Fax:
Practice Address - Street 1:1100 NW 95TH ST
Practice Address - Street 2:NORTH SHORE MEDICAL CENTER
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33150-2038
Practice Address - Country:US
Practice Address - Phone:305-835-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-06
Last Update Date:2014-12-30
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist