Individual
MICHEL-ANGE EDOUARD DESTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4513 NW 31ST AVE, OAKLAND PARK, FL 33309-3403
(202) 855-1545
Mailing address
4513 NW 31ST AVE, OAKLAND PARK, FL 33309-3403
(202) 855-1545
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
23-733
FL
Other
Enumeration date
12/21/2023
Last updated
12/21/2023
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