Healthcare Provider Details

I. General information

NPI: 1831843515
Provider Name (Legal Business Name): 221 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2022
Last Update Date: 11/28/2023
Certification Date: 11/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1435 W 49TH PLACE SUITE 402
HIALEAH FL
33012-3147
US

IV. Provider business mailing address

PO BOX 282071
TAMPA FL
33630-2071
US

V. Phone/Fax

Practice location:
  • Phone: 305-907-8526
  • Fax: 786-534-2493
Mailing address:
  • Phone: 305-928-7249
  • Fax: 305-630-3632

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LAYANSI GARCIA-PUERTO
Title or Position: PRESIDENT
Credential: MD
Phone: 305-928-7249