Individual
MARIANELLA BOUSQUET LA CORTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SA-C
Contact information
Practice address
11301 NW 88TH TER, DORAL, FL 33178-2774
(305) 905-2081
Mailing address
11301 NW 88TH TER, DORAL, FL 33178-2774
(305) 905-2081
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
17-305
FL
Other
Enumeration date
05/23/2017
Last updated
07/21/2022
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