Individual
MICHAEL NIETO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PRESIDENT
Contact information
Practice address
156 NE 8TH ST, HOMESTEAD, FL 33030-4608
(786) 404-3753
(786) 404-3735
Mailing address
156 NE 8TH ST, HOMESTEAD, FL 33030-4608
(786) 404-3753
(786) 404-3735
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
987150
—
FL
Enumeration date
10/10/2022
Last updated
10/10/2022
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