# NOSTRUM MEDICAL CENTER WEST LITTLE HAVANA LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740557495
- **Authorized official:** DR. HENRY LORA M.D. (PRESIDENT)
- **Authorized official phone:** (305) 642-9997

## Contact information

- **Practice address:** 42 NW 27TH AVE STE 401, MIAMI, FL 33125-5135
- **Practice address phone:** (305) 642-9997
- **Practice address fax:** (305) 642-9520
- **Mailing address:** 42 NW 27TH AVE STE 401, MIAMI, FL 33125-5135
- **Mailing address phone:** (305) 642-9997
- **Mailing address fax:** (305) 642-9520

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/23/2011
- **Last updated:** 11/23/2011