Individual
ENZO MIGUEL FORTUNY VIACAVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MSC
Contact information
Practice address
220 ABRAHAM FLEXNER WAY STE 1531, LOUISVILLE, KY 40202-3826
(502) 407-3263
Mailing address
220 ABRAHAM FLEXNER WAY STE 1531, LOUISVILLE, KY 40202-3826
(502) 407-3263
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/13/2020
Last updated
04/13/2020
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