Organization
DAHLIA WIGGAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS LEVI CASTILLO CONSULTANT (CONSULTANT)
(786) 470-4622
Entity
Organization
Contact information
Practice address
662 NE 204TH LN, MIAMI, FL 33179-2436
(305) 725-8836
Mailing address
662 NE 204TH LN, MIAMI, FL 33179-2436
(305) 725-8836
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
01/30/2015
Last updated
01/30/2015
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