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Individual

MRS. GLORIA CASQUERO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
419 W 49TH ST STE 210, HIALEAH, FL 33012-3657
(855) 832-6727
Mailing address
9027 SW 157TH PATH, MIAMI, FL 33196-1196
(305) 606-0441

Taxonomy

Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
021374100
FL
Enumeration date
08/13/2017
Last updated
08/13/2017
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