Provider Demographics
NPI:1295745479
Name:HALEGUA, INO B (MD)
Entity type:Individual
Prefix:
First Name:INO
Middle Name:B
Last Name:HALEGUA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 MINORCA AVE
Mailing Address - Street 2:101
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-4330
Mailing Address - Country:US
Mailing Address - Phone:305-667-6920
Mailing Address - Fax:305-663-2612
Practice Address - Street 1:370 MINORCA AVE
Practice Address - Street 2:101
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-4330
Practice Address - Country:US
Practice Address - Phone:305-667-6920
Practice Address - Fax:305-663-2612
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0022363207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
92572Medicare ID - Type Unspecified
D27648Medicare UPIN