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General NPI Number Information
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NPI Number | 1033794847
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Entity Type | Organization
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Legal Business Name | JWH LITTLE HAVANA, LLC.
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Dates
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Enumeration Date | 03/12/2021
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 1119 SW 1ST. STREET
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City | MIAMI
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State | FL
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Zip | 33130
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Country | US
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Telephone | 305-545-9292
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Fax |
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Provider Business Mailing Address
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Address Line | 9100 S DADELAND BLVD STE 1400
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City | MIAMI
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State | FL
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Zip | 33156-7816
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Country | US
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Telephone | 305-614-4700
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Fax |
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Authorized Official
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Title or Position | DIR OF PROVIDER RELATIONS
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Name | DAIMILSIS SALGADO
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Credential |
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Telephone | 305-614-7740
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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