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Individual

DIMITRI S TAHAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1611 NW 12TH AVE FL 33136, MIAMI, FL 33136-1005
(305) 585-1280
Mailing address
1611 NW 12TH AVE # 118B, MIAMI, FL 33136-1005
(305) 585-1280

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
03/21/2020
Last updated
03/21/2020
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