Provider Demographics
NPI:1003002817
Name:IGLESIAS, NAYVIS (MD)
Entity Type:Individual
Prefix:
First Name:NAYVIS
Middle Name:
Last Name:IGLESIAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3650 NW 82ND AVE
Mailing Address - Street 2:SUITE 502
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6658
Mailing Address - Country:US
Mailing Address - Phone:305-594-9333
Mailing Address - Fax:305-594-0440
Practice Address - Street 1:3650 NW 82ND AVE
Practice Address - Street 2:SUITE 502
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6658
Practice Address - Country:US
Practice Address - Phone:305-594-9333
Practice Address - Fax:305-594-0440
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-15
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 102265207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine