Individual
MR. MARIO TUDELA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA-1936687
Contact information
Practice address
620 NW 33RD AVE, MIAMI, FL 33125-4106
(305) 646-0062
Mailing address
6348 W 22ND LN, HIALEAH, FL 33016-3925
(305) 557-8780
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
MA1936687
FL
Other
Enumeration date
05/04/2007
Last updated
07/08/2007
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