Provider Demographics
NPI:1265415939
Name:PLASENCIA, LUIS (MD)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:
Last Name:PLASENCIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8741 CORAL WAY
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-2005
Mailing Address - Country:US
Mailing Address - Phone:305-226-7800
Mailing Address - Fax:305-551-2953
Practice Address - Street 1:825 SW 87TH AVE # 3C
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-3253
Practice Address - Country:US
Practice Address - Phone:305-552-0109
Practice Address - Fax:305-551-2953
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-27
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME 45681207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine