Individual
MRS. NELLY JENGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
18942 NW 46TH AVE, MIAMI GARDENS, FL 33055-2659
(786) 222-4640
Mailing address
18942 NW 46 AVENUE, MIAMI, FL 33055-2659
(786) 222-4640
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA 52209
FL
Other
Enumeration date
04/05/2010
Last updated
04/05/2010
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