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Individual

MANUEL AFONSO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
200 SE 19TH AVE, POMPANO BEACH, FL 33060-7543
(954) 214-0843
Mailing address
125 N 19TH AVE APT 216, HOLLYWOOD, FL 33020-4550
(786) 848-8103

Taxonomy

Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary

Other

Enumeration date
12/17/2018
Last updated
12/17/2018
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