Individual
MICKEY FUENTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
HOUSE PHYSICIAN-MD
Contact information
Practice address
4300 ALTON RD, MIAMI BEACH, FL 33140-2948
(305) 674-2310
Mailing address
10820 W 33RD WAY, HIALEAH, FL 33018-2194
(786) 338-8754
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
HSE36496
FL
Other
Enumeration date
10/04/2022
Last updated
10/04/2022
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