Provider Demographics
NPI:1164634028
Name:SIGUANEA LLC
Entity Type:Organization
Organization Name:SIGUANEA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALFREDO
Authorized Official - Middle Name:I
Authorized Official - Last Name:RODRIGUEZ-MARTIRENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-557-2949
Mailing Address - Street 1:7100 W 20TH AVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1897
Mailing Address - Country:US
Mailing Address - Phone:305-557-2949
Mailing Address - Fax:305-557-2410
Practice Address - Street 1:7100 W 20TH AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-1897
Practice Address - Country:US
Practice Address - Phone:305-557-2949
Practice Address - Fax:305-557-2410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME56111174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty