Healthcare Provider Details

I. General information

NPI: 1821932336
Provider Name (Legal Business Name): LETICIA DIANA INTEGRATIVE HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2520 SW 22ND ST # 352
MIAMI FL
33145-3438
US

IV. Provider business mailing address

1736 SW 30TH PL
FORT LAUDERDALE FL
33315-2738
US

V. Phone/Fax

Practice location:
  • Phone: 178-662-4079
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: LETICIA DIANA
Title or Position: OWNER
Credential:
Phone: 178-662-4079