Provider Demographics
NPI:1679696785
Name:LAFATA, MARTIN ALEJANDRO (DC)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:ALEJANDRO
Last Name:LAFATA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8850 SW 123RD CT APT H210
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-4151
Mailing Address - Country:US
Mailing Address - Phone:305-218-6500
Mailing Address - Fax:
Practice Address - Street 1:51 E 1ST AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-4909
Practice Address - Country:US
Practice Address - Phone:305-863-8887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 9012111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation