Provider Demographics
NPI:1679789747
Name:FLAVIA A INESTA INC
Entity type:Organization
Organization Name:FLAVIA A INESTA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FLAVIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:INESTA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:786-828-7221
Mailing Address - Street 1:360 SW 18TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33129-1019
Mailing Address - Country:US
Mailing Address - Phone:786-828-7221
Mailing Address - Fax:786-828-7131
Practice Address - Street 1:1330 SW 22ND ST STE 311
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-2945
Practice Address - Country:US
Practice Address - Phone:786-828-7221
Practice Address - Fax:786-828-7131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2720213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL390411302Medicaid
FL65567OtherBCBS
FL65567Medicare PIN
FL390411302Medicaid