Individual
LESTER OMAR CARVAJALES DIEGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1893 NE MIAMI GARDENS DR, NORTH MIAMI BEACH, FL 33179-5035
(305) 682-0080
Mailing address
6420 SW 139TH AVENUE RD APT 302, MIAMI, FL 33183-2520
(786) 970-9301
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
31913
FL
Other
Enumeration date
06/01/2022
Last updated
06/01/2022
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