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Organization

LETICIA ADAN MD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHARISSE MAJELLA DISTURA JINGCO (OFFICE MANAGER)
(305) 531-1664
Entity
Organization

Contact information

Practice address
4302 ALTON RD STE 420, MIAMI BEACH, FL 33140-2849
(305) 531-1664
(305) 531-9965
Mailing address
4302 ALTON RD STE 420, MIAMI BEACH, FL 33140-2849
(305) 216-5048
(305) 531-9965

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
38275
BLUE CROSS BLUE SHIELD
FL
01
DB3262
RAILROAD MEDICARE
FL
Enumeration date
06/02/2006
Last updated
09/07/2022
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