Individual
MR. JOHAN MENNIG SAN ROMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
975 BAPTIST WAY, HOMESTEAD, FL 33033-7600
(305) 793-4706
Mailing address
6634 SW 114TH PL, UNIT A, MIAMI, FL 33173-1783
(305) 793-4706
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA3409
FL
Other
Enumeration date
11/29/2007
Last updated
11/29/2007
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