Individual
DOLORES LOURDES PAEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3010 E 138TH AVE STE 12, TAMPA, FL 33613-3999
(813) 975-2800
Mailing address
1012 BALAYE VISTA CIR APT 301, TAMPA, FL 33619-7602
(810) 240-7340
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
30030
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30030
HOUSE PHYSICIAN LICENSE
FL
Enumeration date
11/11/2022
Last updated
11/11/2022
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