Individual
JOHANA COBO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8624 LEE VISTA BLVD, ORLANDO, FL 32829-8310
(786) 246-2483
Mailing address
7882 JUBILEE PARK BLVD APT 726, ORLANDO, FL 32822-5221
(786) 246-2483
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN24178
FL
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/20/2018
Last updated
06/28/2019
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