Individual
MARIA FUENTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12555 ORANGE DR, SUITE 222, DAVIE, FL 33330-4304
(954) 862-1707
Mailing address
4111 STIRLING RD, APT 209, DAVIE, FL 33314-7535
(954) 549-6558
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002816300
—
FL
Enumeration date
02/15/2011
Last updated
02/15/2011
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