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Individual

FITZ PHILOGENE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
A.P.

Contact information

Practice address
3900 NW 79TH AVE, SUITE 598, DORAL, FL 33166-6556
(786) 715-6380
Mailing address
12620 NW 12TH AVE, NORTH MIAMI, FL 33168-6504
(786) 715-6380

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
3514
FL

Other

Enumeration date
09/22/2014
Last updated
09/22/2014
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