Individual
LEODAN LANTIGUA SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
960 SW 82 AVE, MIAMI, FL 33144
(305) 266-7556
(305) 266-7557
Mailing address
PO BOX 440846, MIAMI, FL 33144-0846
(305) 266-7556
(305) 266-7557
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
OS12142
FL
261Q00000X
Clinic/Center
HCC8713
FL
Other
Enumeration date
03/24/2016
Last updated
03/24/2016
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