Individual
OMAR MATOS WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12036 SW 42ND ST APT 303, MIRAMAR, FL 33025-7982
(305) 479-1145
Mailing address
12036 SW 42ND ST APT 303, MIRAMAR, FL 33025-7982
(305) 479-1145
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/12/2024
Last updated
03/12/2024
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