Individual
MANUEL DE LA PUERTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2767 NW 26TH PL, GAINESVILLE, FL 32605-2842
(352) 316-4843
Mailing address
2767 NW 26TH PL, GAINESVILLE, FL 32605-2842
(352) 264-2542
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
ME67324
FL
207RX0202X
Medical Oncology Physician
Primary
ME67324
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
261472300
—
FL
Enumeration date
09/15/2005
Last updated
04/28/2023
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