Individual
JORGE LUIS CARRILLO MOYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
HSE
Contact information
Practice address
1321 NW 14TH ST BLDG SUITE505, MIAMI, FL 33125-1673
(305) 243-6704
(305) 243-6191
Mailing address
1321 NW 14TH ST BLDG SUITE505, MIAMI, FL 33125-1673
(305) 243-6704
(305) 243-6191
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
HSE36492
FL
Other
Enumeration date
06/12/2023
Last updated
06/12/2023
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