Individual
DAISY ROCHART REVILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
9735 FONTAINEBLEAU BLVD # G203, MIAMI, FL 33172-6724
(786) 525-0215
Mailing address
9735 FONTAINEBLEAU BLVD # G203, MIAMI, FL 33172-6724
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
355744
FL
Other
Enumeration date
06/10/2021
Last updated
06/10/2021
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