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Individual

DR. ILEANA FUENTES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3601 FEDERAL HWY, MIAMI, FL 33137-3795
(305) 576-6611
(305) 576-0008
Mailing address
3601 FEDERAL HWY, MIAMI, FL 33137-3795
(305) 576-6611
(786) 476-2819

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME75683
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
254911500
FL
01
E1661Z
MEDICARE
FL
Enumeration date
11/01/2006
Last updated
10/31/2023
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