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Individual

LUIS MARIANO ROQUETA SR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
SURGICAL ASSISTANT

Contact information

Practice address
1190 NW 95TH ST, STE # 306, MIAMI, FL 33150-2063
(305) 693-0000
Mailing address
1190 NW 95TH ST, STE # 306, MIAMI, FL 33150-2063
(305) 693-0000

Taxonomy

Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
13-486
CO

Other

Enumeration date
02/22/2014
Last updated
02/22/2014
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