Individual
THALIA CONDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1205 4TH ST, KEY WEST, FL 33040-3707
(305) 434-7660
Mailing address
1205 4TH ST, KEY WEST, FL 33040-3707
(305) 434-7660
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
—
Enumeration date
10/05/2020
Last updated
10/05/2020
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