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General NPI Number Information
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NPI Number | 1578762126
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Entity Type | Organization
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Legal Business Name | LISETTE NOGUES MD PA
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Dates
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Enumeration Date | 07/13/2007
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Last Update Date | 03/15/2012
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Provider Practice Location Address
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Address Line | 8525 SW 92ND ST SUITE D 16
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City | MIAMI
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State | FL
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Zip | 33156-7365
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Country | US
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Telephone | 305-412-4545
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Fax | 786-242-6679
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Provider Business Mailing Address
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Address Line | 11800 SW 87TH AVE
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City | MIAMI
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State | FL
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Zip | 33176-4307
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Country | US
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Telephone | 305-412-4545
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Fax | 786-242-6679
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LISETTE NOGUES
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Credential | MD
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Telephone | 305-412-4545
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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 | ME0045561
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License Number State | FL
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