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General NPI Number Information
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NPI Number | 1558436667
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Entity Type | Organization
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Legal Business Name | LITTLE HAVANA ACTIVITIES & NUTRITION CENTERS OF DADE COUNTY, INC.
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Dates
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Enumeration Date | 11/22/2006
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Last Update Date | 02/02/2024
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Provider Practice Location Address
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Address Line | 700 SW 8TH ST
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City | MIAMI
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State | FL
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Zip | 33130-3311
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Country | US
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Telephone | 305-860-3988
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Fax | 305-854-2226
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Provider Business Mailing Address
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Address Line | 700 SW 8TH ST
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City | MIAMI
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State | FL
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Zip | 33130-3311
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Country | US
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Telephone | 305-860-3988
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Fax | 305-854-2226
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RAFAEL IGLESIAS
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Credential |
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Telephone | 305-858-0887
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | FL
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