Individual
JORGE LUIS ULLOA CAPESTANY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
6865 W 7TH AVE APT 408, HIALEAH, FL 33014-4877
(786) 307-2572
Mailing address
6865 W 7TH AVE APT 408, HIALEAH, FL 33014-4877
(786) 307-2572
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
11010052
FL
Other
Enumeration date
11/08/2020
Last updated
11/09/2020
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