Individual
RACIEL LEONARDO BORREGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1068 W 44TH ST, HIALEAH, FL 33012-4110
(786) 380-2123
Mailing address
1068 W 44TH ST, HIALEAH, FL 33012-4110
(786) 380-2123
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
11039894
FL
Other
Enumeration date
06/03/2025
Last updated
06/03/2025
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