Individual
JARVIS VIZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA, SA-C
Contact information
Practice address
20121 SW 117TH AVE, MIAMI, FL 33177
(939) 217-2931
Mailing address
20121 SW 117TH AVE, MIAMI, FL 33177-5455
(939) 217-2931
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
027
PR
Other
Enumeration date
03/30/2017
Last updated
05/22/2019
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