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Individual

MARIA L MIRABAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
756 W PALM DR, FLORIDA CITY, FL 33034-3224
(305) 246-3530
(305) 246-4686
Mailing address
1408 E MOWRY DR APT 203, HOMESTEAD, FL 33033-4935
(786) 354-2315

Taxonomy

Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5590839562
FL
Enumeration date
08/07/2017
Last updated
08/07/2017
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