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Individual

ENRIQUE GARBAYO OTANO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
SA-C

Contact information

Practice address
6686 SW 103RD CT, MIAMI, FL 33173-1314
(786) 451-4551
Mailing address
6686 SW 103RD CT, MIAMI, FL 33173-1314
(786) 451-4551

Taxonomy

Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
RN9650944
FL
246ZC0007X
Surgical Assistant
15-268
WI

Other

Enumeration date
04/19/2018
Last updated
03/19/2024
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