Healthcare Provider Details

I. General information

NPI: 1063266385
Provider Name (Legal Business Name): CLARA HUEBRA BEGUIRISTAIN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2024
Last Update Date: 08/23/2024
Certification Date: 08/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 N 35TH AVE STE 555
HOLLYWOOD FL
33021-5431
US

IV. Provider business mailing address

1650 S LE JEUNE RD APT 105
MIAMI FL
33134-3800
US

V. Phone/Fax

Practice location:
  • Phone: 561-929-2901
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License Number9118561
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: