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General NPI Number Information
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NPI Number | 1821525999
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Entity Type | Individual
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Provider Name | MADILAN ALFARO IGLESIAS
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Gender | Female
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Dates
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Enumeration Date | 05/18/2017
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Last Update Date | 05/18/2017
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Provider Practice Location Address
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Address Line | 3750 W 16TH AVE
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City | HIALEAH
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State | FL
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Zip | 33012-4654
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Country | US
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Telephone | 305-231-3371
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Fax | 305-231-3382
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Provider Business Mailing Address
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Address Line | 3820 W 11TH AVE # 33
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City | HIALEAH
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State | FL
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Zip | 33012-4162
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Country | US
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Telephone | 305-300-5262
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA27242
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License Number State | FL
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