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General NPI Number Information
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NPI Number | 1326988502
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Entity Type | Organization
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Legal Business Name | EQUILIBRIUM INN CORP
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Dates
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Enumeration Date | 03/30/2026
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Last Update Date | 03/30/2026
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Provider Practice Location Address
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Address Line | 11140 N KENDALL DR STE 110
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City | MIAMI
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State | FL
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Zip | 33176-0901
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Country | US
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Telephone | 786-334-2494
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Fax |
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Provider Business Mailing Address
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Address Line | 13818 SW 152ND ST
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City | MIAMI
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State | FL
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Zip | 33177-1164
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RUSDANY COLLADO FUENTES
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Credential | MD
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Telephone | 305-502-3553
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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