Provider Demographics
NPI:1366150815
Name:IREISA LLC
Entity type:Organization
Organization Name:IREISA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ISAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:IZAGUIRRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-413-4815
Mailing Address - Street 1:6248 MIRAMAR PKWY
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023
Mailing Address - Country:US
Mailing Address - Phone:786-413-4815
Mailing Address - Fax:
Practice Address - Street 1:6248 MIRAMAR PKWY
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023
Practice Address - Country:US
Practice Address - Phone:786-413-4815
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM3000XAmbulatory Health Care FacilitiesClinic/CenterMedically Fragile Infants and Children Day Care