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Organization
SRC PROFESIONAL CORP
Active
Organization
SRC PROFESIONAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SERGIO RODRIGUEZ-CHAPLE (ARNP)
(786) 237-9124
Entity
Organization
Contact information
Practice address
13925 SW 179TH ST, MIAMI, FL 33177-7743
(786) 237-9124
Mailing address
13925 SW 179TH ST, MIAMI, FL 33177-7743
(786) 237-9124
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/09/2019
Last updated
05/09/2019
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