Provider Demographics
NPI:1568651248
Name:CAPOTE, HELEN
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:
Last Name:CAPOTE
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 1:12533 SW 147TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-7468
Mailing Address - Country:US
Mailing Address - Phone:786-554-1578
Mailing Address - Fax:305-448-8312
Practice Address - Street 1:3808 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-3002
Practice Address - Country:US
Practice Address - Phone:786-554-1578
Practice Address - Fax:305-448-8312
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-18
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC130380548880OtherDRIVER LICENSE
FL4185812429255224OtherCREDI CARD