Individual
FANNY ESMERALDA VIGNOLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.T.(R)(CT)(MR)(ARRT
Contact information
Practice address
9600 NW 25TH ST STE 3D, DORAL, FL 33172-1416
(800) 972-9114
(866) 236-5409
Mailing address
9600 NW 25TH ST STE 3D, DORAL, FL 33172-1416
(800) 972-9114
(866) 236-5409
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
CRT54658
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CRT54658
DOH
FL
Enumeration date
05/17/2020
Last updated
06/07/2024
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