ILEANA FUENTES MD, PA
Medical Practice at Flagler St, Miami, FL

License number
Florida ME75683
Category
Medical Practice
Type
Pediatrics
Owner
Name: DR. ILEANA FUENTES M.D.
Title: PRESIDENT
Phone: (305) 588-4290
Address
Address
4343 W Flagler St STE 210, Miami, FL 33134
National Provider ID: 1134535198
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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ILEANA FUENTES, M.D., PA

4343 W Flagler St 210, Miami, FL 33134

Registration:
Jan 31, 2000
State ID:
P00000010139
Business type:
Florida Profit Corporation
Ileana Fuentes, 3150 SW 108 Ave, Miami, FL 33165 (Physical)
Agent:
Fuentes, Ileana,3150 SW 108 Ave, Miami, FL 33165 (Physical)
FEI/EIN:
650976412

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