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General NPI Number Information
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NPI Number | 1871787440
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Entity Type | Organization
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Legal Business Name | NIDIA M IGLESIAS MD PA
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Dates
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Enumeration Date | 08/28/2007
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Last Update Date | 10/17/2012
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Provider Practice Location Address
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Address Line | 4302 ALTON RD SUITE 560
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City | MIAMI BEACH
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State | FL
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Zip | 33140-2891
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Country | US
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Telephone | 305-531-0820
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Fax | 305-531-0920
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Provider Business Mailing Address
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Address Line | 4302 ALTON RD SUITE 560
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City | MIAMI BEACH
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State | FL
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Zip | 33140-2891
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Country | US
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Telephone | 305-531-0820
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Fax | 305-531-0920
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. NIDIA M IGLESIAS
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Credential | MD
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Telephone | 305-531-0820
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME59981
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License Number State | FL
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