Organization
ILEANA FUENTES MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ILEANA FUENTES M.D. (PRESIDENT)
(305) 588-4290
Entity
Organization
Contact information
Practice address
4343 W FLAGLER ST STE 210, CORAL GABLES, FL 33134-1586
(305) 588-4290
Mailing address
3150 SW 108TH AVE, MIAMI, FL 33165-2450
(305) 588-4290
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME75683
FL
Other
Enumeration date
07/10/2014
Last updated
07/10/2014
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