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ADENS PREVILON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
10794 PINES BLVD STE 205, PEMBROKE PINES, FL 33026-3920
(954) 538-8543
(954) 431-8153
Mailing address
10794 PINES BLVD STE 205, PEMBROKE PINES, FL 33026-3920
(954) 538-8543
(954) 431-8153

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
009738
NY
363A00000X
Physician Assistant
Primary
PA9103610
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
006737400
FL
Enumeration date
07/08/2006
Last updated
11/11/2021
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