Provider Demographics
NPI:1467583344
Name:PUENTES, MAGALYS
Entity Type:Individual
Prefix:MISS
First Name:MAGALYS
Middle Name:
Last Name:PUENTES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16919 NORHT BAY RD
Mailing Address - Street 2:# 918
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33132-4220
Mailing Address - Country:US
Mailing Address - Phone:305-949-1808
Mailing Address - Fax:305-945-5134
Practice Address - Street 1:16919 NORHT BAY RD
Practice Address - Street 2:APT 918
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33132-4220
Practice Address - Country:US
Practice Address - Phone:305-949-1808
Practice Address - Fax:305-945-5134
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCNA 28902364SH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SH0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistHome Health