Organization
LITTLE HAVANA ACTIVITIES AND NUTRTION CENTERS OF DADE COUNTY
Active
Other names
LHANC - DIVERSION PALM BEACH
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAFAE; IGLESIAS (CEO/PRESDIENT)
(305) 858-0887
Entity
Organization
Contact information
Practice address
700 SW 8TH ST, MIAMI, FL 33130-3311
(305) 858-0887
(305) 854-2226
Mailing address
700 SW 8TH ST, MIAMI, FL 33130-3311
(305) 858-0887
(305) 854-2226
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015040102
—
FL
Enumeration date
05/22/2008
Last updated
06/07/2021
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