Individual
RAIZA DE LEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N
Contact information
Practice address
4920 E 4TH AVE, HIALEAH, FL 33013-1509
(305) 364-8858
Mailing address
4920 E 4TH AVE, HIALEAH, FL 33013-1509
(305) 364-8858
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
PH27197
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PH27197
BOARD OF PHARMACY
FL
Enumeration date
11/06/2013
Last updated
11/06/2013
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