Provider Demographics
NPI:1528637303
Name:LA DOCTORA TERAPISTA LLC
Entity type:Organization
Organization Name:LA DOCTORA TERAPISTA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERLINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-602-6548
Mailing Address - Street 1:7512 NW 107TH PL
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-2197
Mailing Address - Country:US
Mailing Address - Phone:786-602-6548
Mailing Address - Fax:
Practice Address - Street 1:7512 NW 107TH PL
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-2197
Practice Address - Country:US
Practice Address - Phone:786-602-6548
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center