Healthcare Provider Details

I. General information

NPI: 1497541411
Provider Name (Legal Business Name): LEAGUE AGAINST AIDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2025
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1435 W 49TH PL STE 503
HIALEAH FL
33012-3158
US

IV. Provider business mailing address

1435 W 49TH PL STE 503
HIALEAH FL
33012-3158
US

V. Phone/Fax

Practice location:
  • Phone: 305-787-3267
  • Fax: 305-787-3267
Mailing address:
  • Phone: 305-787-3267
  • Fax: 305-787-3267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DAVID STEVEN ADAN
Title or Position: DIRECTOR OF VALUE CARE
Credential:
Phone: 786-787-3267