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General NPI Number Information
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NPI Number | 1104954668
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Entity Type | Organization
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Legal Business Name | LA CLINICA LATINA INC
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 04/20/2009
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Provider Practice Location Address
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Address Line | 1070 SW 1ST ST
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City | MIAMI
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State | FL
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Zip | 33130-1009
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Country | US
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Telephone | 305-545-0055
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Fax | 305-545-0066
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Provider Business Mailing Address
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Address Line | 1070 SW 1ST ST
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City | MIAMI
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State | FL
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Zip | 33130-1009
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Country | US
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Telephone | 305-545-0055
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Fax | 305-545-0066
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALEJANDRO F FERRAS
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Credential | M.D.
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Telephone | 305-545-0055
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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 | HCC5379
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License Number State | FL
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