Individual
KANSON ETIENNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
55 NE 117TH ST, MIAMI, FL 33161-6639
(305) 985-6176
Mailing address
11846 W DIXIE HWY, MIAMI, FL 33161-6108
(305) 985-6176
(305) 749-9983
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
FL
Other
Enumeration date
12/26/2022
Last updated
12/27/2022
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