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General NPI Number Information
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NPI Number | 1194184192
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Entity Type | Individual
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Provider Name | EDUARDO ANTONIO GOENAGA IGLESIAS FNP,ARNP,CSA
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Gender | Male
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Dates
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Enumeration Date | 02/18/2016
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Last Update Date | 11/21/2025
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Provider Practice Location Address
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Address Line | 390 NE 135TH ST
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City | NORTH MIAMI
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State | FL
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Zip | 33161-3967
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Country | US
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Telephone | 872-231-3162
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 22239
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City | NEW YORK
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State | NY
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Zip | 10087-0001
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Country | US
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Telephone | 702-899-0595
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Fax | 702-977-1496
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11023831
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License Number State | FL
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