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Individual

MIRACLE GEORGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
737 SW 109TH AVE, APT. 408, MIAMI, FL 33174-1339
(601) 540-7284
Mailing address
737 SW 109TH AVE, MIAMI, FL 33174-1339
(601) 540-7284

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
802316657
MS

Other

Enumeration date
04/22/2020
Last updated
04/22/2020
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