Individual
JUAN ANTONIO SAN BLAS VALDES SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 SW 110TH AVE APT 125, MIAMI, FL 33174-1255
(305) 560-0853
Mailing address
100 SW 110TH AVE APT 125, MIAMI, FL 33174-1255
(305) 560-0853
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
13-664
FL
Other
Enumeration date
07/23/2015
Last updated
07/23/2015
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