Individual
DIANA BORREL MOLDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4384 SW 12TH ST, MIAMI, FL 33134-2713
(305) 448-6121
Mailing address
4384 SW 12TH ST, MIAMI, FL 33134-2713
(305) 448-6121
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PS15470
FL
Other
Enumeration date
12/29/2011
Last updated
12/29/2011
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