1215154299 NPI number — HELENA IGRA, MD, PA

Table of content: (NPI 1215154299)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215154299 NPI number — HELENA IGRA, MD, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HELENA IGRA, MD, PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215154299
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/21/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
777 ARTHUR GODFREY RD
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
MIAMI BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33140-3449
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-672-6868
Provider Business Mailing Address Fax Number:
305-672-8281

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
777 ARTHUR GODFREY RD
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
MIAMI BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33140-3449
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-672-6868
Provider Business Practice Location Address Fax Number:
305-672-8281
Provider Enumeration Date:
04/19/2007

Additional Information

Authorized Official

Authorized Official Last Name:
IGRA
Authorized Official First Name:
HELENA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
305-672-6868

Provider Taxonomy Codes

  • Taxonomy code: 207NS0135X , with the licence number:  ME78677 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 228080 . This is a "AETNA HMO" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 4407885 . This is a "AETNA PPO/POS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 47064 . This is a "BLUE CROSS BLUE SHIELD OF FLA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: E70543 . This is a "AVMED" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 0019201 . This is a "CIGNA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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