Provider Demographics
NPI:1760456420
Name:INESTA, FLAVIA A (DPM)
Entity Type:Individual
Prefix:DR
First Name:FLAVIA
Middle Name:A
Last Name:INESTA
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1797 SW 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33129-1492
Mailing Address - Country:US
Mailing Address - Phone:305-856-4454
Mailing Address - Fax:305-856-4456
Practice Address - Street 1:2223 SW 13TH AVE STE A
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-3972
Practice Address - Country:US
Practice Address - Phone:305-773-9554
Practice Address - Fax:305-854-0027
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-16
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 2720213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL65567OtherBCBS
FL390411302Medicaid
FL65567Medicare PIN