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General NPI Number Information
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NPI Number | 1548534597
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Entity Type | Organization
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Legal Business Name | ENRIQUE J HUERTAS JR MD PA
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Dates
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Enumeration Date | 03/07/2012
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Last Update Date | 03/07/2012
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Provider Practice Location Address
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Address Line | 1831 NW 7TH ST
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City | MIAMI
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State | FL
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Zip | 33125-3503
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Country | US
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Telephone | 305-649-4117
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Fax | 305-649-4207
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Provider Business Mailing Address
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Address Line | 1831 NW 7TH ST
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City | MIAMI
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State | FL
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Zip | 33125-3503
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Country | US
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Telephone | 305-649-4117
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Fax | 305-649-4207
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Authorized Official
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Title or Position | OWNER
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Name | ENRIQUE HUERTAS
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Credential | MD
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Telephone | 305-649-4117
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | ME 44902
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License Number State | FL
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