Healthcare Provider Details

I. General information

NPI: 1811445570
Provider Name (Legal Business Name): JOAN LETANG RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2016
Last Update Date: 09/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1929 NE 181ST ST
NORTH MIAMI BEACH FL
33162-1613
US

IV. Provider business mailing address

1929 NE 181ST ST
NORTH MIAMI BEACH FL
33162-1613
US

V. Phone/Fax

Practice location:
  • Phone: 786-278-5374
  • Fax:
Mailing address:
  • Phone: 786-278-5374
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License NumberRT 12501
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: