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General NPI Number Information
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NPI Number | 1548774458
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Entity Type | Individual
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Provider Name | JUAN ENRIQUE LAFOSSE
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Gender | Male
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Dates
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Enumeration Date | 11/30/2017
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | 4860 SW 94TH CT
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City | MIAMI
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State | FL
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Zip | 33165
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Country | US
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Telephone | 954-515-7965
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Fax |
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Provider Business Mailing Address
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Address Line | 425 W COLONIAL DR STE 303
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City | ORLANDO
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State | FL
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Zip | 32804-6863
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Country | US
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Telephone | 954-515-7965
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 9343124
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License Number State | FL
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