Individual
MR. MIGUEL A PUENTES SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8411 HERON POND DR APT B110, LEHIGH ACRES, FL 33972-8548
(239) 288-9470
Mailing address
PO BOX 516, LEHIGH ACRES, FL 33970-0516
(239) 288-9470
Taxonomy
Speciality
Code
Description
License number
State
171R00000X
Interpreter
Primary
P532-541-55-349-0
FL
171W00000X
Contractor
P532-541-55-349-0
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P532-541-55-349-0
FLDL
FL
Enumeration date
02/02/2018
Last updated
02/02/2018
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