Individual
LISANDRA NODARSE CONSUEGRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
823 E 31ST ST, HIALEAH, FL 33013-3428
(305) 216-5396
Mailing address
823 E 31ST ST, HIALEAH, FL 33013-3428
(305) 216-5396
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN28199
FL
261QS1000X
Student Health Clinic/Center
—
—
Other
Enumeration date
05/03/2023
Last updated
06/22/2023
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