Individual
MR. JOSE PENAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
10300 SW 216TH STREET, WALK-INS SERVICE DEPT, CUTLER BAY, FL 33190
(305) 235-5100
Mailing address
10300 SW 216TH ST, CUTLER BAY, FL 33190-1003
(305) 253-5100
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
9101022
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9101022
STATE LICENSE
FL
Enumeration date
01/31/2007
Last updated
04/18/2019
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