Healthcare Provider Details

I. General information

NPI: 1679789747
Provider Name (Legal Business Name): FLAVIA A INESTA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 SW 22ND ST STE 311
MIAMI FL
33145-2945
US

IV. Provider business mailing address

360 SW 18TH TER
MIAMI FL
33129-1019
US

V. Phone/Fax

Practice location:
  • Phone: 786-828-7221
  • Fax: 786-828-7131
Mailing address:
  • Phone: 786-828-7221
  • Fax: 786-828-7131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO2720
License Number StateFL

VIII. Authorized Official

Name: FLAVIA A INESTA
Title or Position: PRESIDENT
Credential: DPM
Phone: 786-828-7221