Individual
KEVIN SANTIAGO ENOBAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
5800 S UNIVERSITY DR, DAVIE, FL 33328-6102
(954) 252-2583
Mailing address
PO BOX 279037, MIRAMAR, FL 33027-9037
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC6535
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/10/2024
Last updated
07/10/2024
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