Individual
MR. JOSE ANTONIO PUERTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
18610 NW 87TH AVE, SUITE 101 AND 201, HIALEAH, FL 33015-3518
(305) 829-5000
(305) 829-5033
Mailing address
8400 NW 33RD ST, SUITE 201, DORAL, FL 33122-1937
(786) 408-8502
(305) 402-0855
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9100243
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292159600
—
FL
Enumeration date
07/07/2006
Last updated
09/29/2016
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