# JUVENTUD CORPORATION

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

## Provider details

- **NPI number:** 1750390647
- **Authorized official:** JUAN CARLOS PRADO SR. (PRESIDENT/OWNER)
- **Authorized official phone:** (786) 390-9295

## Contact information

- **Practice address:** 1701 W FLAGLER ST, SUITE 308, MIAMI, FL 33135-2098
- **Practice address phone:** (305) 646-0440
- **Practice address fax:** (305) 646-0405
- **Mailing address:** 1701 W FLAGLER ST, SUITE 308, MIAMI, FL 33135-2098
- **Mailing address phone:** (305) 646-0440
- **Mailing address fax:** (305) 646-0405

## Taxonomy

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

## Other

- **Enumeration date:** 08/07/2006
- **Last updated:** 08/22/2020