Individual
ODALYS PURI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
8260 W FLAGLER ST STE 2G, MIAMI, FL 33144-2069
(786) 286-7977
Mailing address
9176 SW 138PL, MIAMI, FL 33186
(786) 286-9134
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA51643
FL
Other
Enumeration date
07/01/2011
Last updated
07/01/2011
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