Individual
DANILO IBARRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1650 NE 26TH ST, SUITE 101, WILTON MANORS, FL 33305-1431
(954) 564-6573
(954) 564-6513
Mailing address
1650 NE 26TH ST, SUITE 101, WILTON MANORS, FL 33305-1431
(954) 564-6573
(954) 564-6513
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
MA52106
FL
174400000X
Specialist
Primary
MA52106
FL
Other
Enumeration date
10/09/2008
Last updated
10/09/2008
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