DR. IRINA LICEA (NPI# 1649454091) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649454091 |
| Entity Type | Individual |
| Full Name | DR. IRINA LICEA |
| Credential | MD |
| Practice Address |
1321 Nw 14th St Ste 102 Miami FL 33125-1653 |
| Practice Telephone | 3055454980 |
| Practice Fax Number | 3055454913 |
| Mailing Telephone | 3055454980 |
| Mailing Fax Number | 3055454913 |
| Enumeration Date | 2007-12-20 |
| Last Update Date | 2014-06-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | ME 100912 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
1321 NW 14TH ST STE 102 |
| City | MIAMI |
| State | FL |
| Zip Code | 33125-1653 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316110653 | Raul Roa | Family Medicine | 1321 Nw 14th St Ste 102, Miami, FL 33125-1653 | 2008-04-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053912469 | Loves Community Mental Health Inc | Clinic/Center | 2 Nw 30th Ave, Miami, FL 33125 | 2020-11-03 |
| 1548872971 | Easter Seals South Florida, Inc. | Home Health | 1475 Nw 14 Ave, Miami, FL 33125 | 2020-08-18 |
| 1295368991 | Stellar Alf II LLC | Assisted Living Facility | 3055 N.w. Flagler Terr., Miami, FL 33125 | 2020-02-20 |
| 1841773546 | Enmanuel Alejandro Iglesias | Speech-Language Pathologist | Thera-pro Care,llc 888 Nw 27 Avenue, Suite 5, Miami, FL 33125 | 2018-09-10 |
| 1588158117 | Josefina Cammarano De Casas | Behavior Technician | 720 Nw 19th Ct., Miami, FL 33125 | 2018-06-18 |
| 1861984262 | Patricia Gabbidon | Audiologist | 1201 Nw 16th St Rm 2a151, Miami, FL 33125 | 2018-05-31 |
| 1154829471 | Iviana Tamara Farinas | Nurse Practitioner | 1951 Nw 7th Street, Miami, FL 33125 | 2018-02-01 |
| 1316452634 | Dayana A Perez Del Pozo | Physical Therapy Assistant | 1422 Nw 7th Street, Marlins Park Third Base Entrance, Miami, FL 33125 | 2017-12-08 |
| 1275046831 | Galaxy Wellness Sport and Rehabilitation Center LLC | Orthopaedic Surgery | 1951 Nw 7th St, Miami, FL 33125 | 2017-11-06 |
| 1609398247 | Yaremi Ramirez | Behavioral Analyst | 2145 Nw 13th St, Miami, FL 33125 | 2017-07-14 |
| Find all providers in zip 33125 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053912550 | Wound Integrity Florida Pa | Family Medicine | 111 Ne 1st St # 1011, Miami, FL 33132-2506 | 2020-11-03 |
| 1700486933 | Orlando Jorge Diaz | Family Medicine | 6231 Sw 138th Ct Apt N, Miami, FL 33183-2095 | 2020-10-27 |
| 1386242402 | Michelle Andrea Von Der Heyde | Family Medicine | 2806 Sw 145th Ct, Miami, FL 33175-7479 | 2020-10-12 |
| 1558968008 | Vera Medical Practice LLC | Family Medicine | 6741 Coral Way Ste 44, Miami, FL 33155-1767 | 2020-10-07 |
| 1396342069 | Navarro Medical Centers LLC | Family Medicine | 10240 Sw 56th St Ste 101, Miami, FL 33165-7066 | 2020-10-06 |
| 1477160513 | Marta Yamilex Herrera Lorenzo | Family Medicine | 500 Sw 120th Ave, Miami, FL 33184-1643 | 2020-09-23 |
| 1336753482 | Vielka D Centeno | Family Medicine | 13244 Sw 111th Ter Apt 2, Miami, FL 33186-4364 | 2020-09-06 |
| 1164031670 | Yanet Ybanez Alvarez | Family Medicine | 6201 Coral Lake Dr, Miami, FL 33155-5938 | 2020-07-30 |
| 1093323107 | Jalima Jimenez Morejon | Family Medicine | 23103 Sw 107th Pl, Miami, FL 33170-7545 | 2020-07-15 |
| 1548878655 | Lisandra Franco Porto | Family Medicine | 2001 Ludlam Rd Apt 335, Miami, FL 33155-1898 | 2020-07-15 |
| Find all providers in MIAMI | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.