Individual
CRISTEVY M. VIDAL GOMEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
4324 NW 115TH CT, DORAL, FL 33178-4229
(978) 905-9124
Mailing address
4324 NW 115TH CT, DORAL, FL 33178-4229
(978) 905-9124
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
—
—
Other
Enumeration date
09/29/2022
Last updated
09/29/2022
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