Provider Demographics
NPI:1609640473
Name:SOUTH FLORIDA PRACTITIONERS & ASSOCIATES LLC
Entity Type:Organization
Organization Name:SOUTH FLORIDA PRACTITIONERS & ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADIANEZ
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA AGUILA
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:786-298-4573
Mailing Address - Street 1:12349 SW 251ST TER
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-5928
Mailing Address - Country:US
Mailing Address - Phone:786-298-4573
Mailing Address - Fax:
Practice Address - Street 1:15600 SW 288TH ST STE 105
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-1200
Practice Address - Country:US
Practice Address - Phone:786-298-4573
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-13
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty