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General NPI Number Information
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NPI Number | 1518267343
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Entity Type | Organization
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Legal Business Name | LYSETTE IGLESIAS, M.D, P.A
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Dates
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Enumeration Date | 10/26/2010
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Last Update Date | 12/14/2011
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Provider Practice Location Address
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Address Line | 2387 W 68TH ST SUITE 301
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City | HIALEAH
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State | FL
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Zip | 33016-6889
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Country | US
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Telephone | 305-381-5301
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Fax | 305-381-5541
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Provider Business Mailing Address
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Address Line | 8031 NW 169TH TER
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City | MIAMI LAKES
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State | FL
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Zip | 33016-3430
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Country | US
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Telephone | 305-639-0446
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Fax | 305-381-5541
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Authorized Official
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Title or Position | PEDIATRIC ENDOCRINOLOGIST
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Name | DR. LYSETTE IGLESIAS
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Credential | M.D
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Telephone | 305-639-0446
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0205X
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Taxonomy Name | Pediatric Endocrinology Physician
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License Number | ME 99374
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License Number State | FL
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