Individual
DIANA CAROLINA VILLALBA PENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SA-C
Contact information
Practice address
555 S LUNA CT APT 111, HOLLYWOOD, FL 33021-7564
(954) 554-2445
Mailing address
555 S LUNA CT APT 111, HOLLYWOOD, FL 33021-7564
(954) 554-2445
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
20-398
FL
Other
Enumeration date
10/17/2020
Last updated
10/17/2020
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