Individual
YUSMEL MIRABAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
210 E GRAY ST STE 1105, LOUISVILLE, KY 40202-3907
(502) 583-1697
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2569
KY
Other
Enumeration date
11/18/2019
Last updated
10/26/2020
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