Healthcare Provider Details

I. General information

NPI: 1184425852
Provider Name (Legal Business Name): AMARA HEALTH CENTER CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2025
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15935 NW 57TH AVE
MIAMI LAKES FL
33014-6703
US

IV. Provider business mailing address

15935 NW 57TH AVE
MIAMI LAKES FL
33014-6703
US

V. Phone/Fax

Practice location:
  • Phone: 786-801-7577
  • Fax:
Mailing address:
  • Phone: 786-801-7577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NADIEZHDA ESTEBAN FOLGAR
Title or Position: PRESIDENT
Credential:
Phone: 786-801-7577