Individual
JUAN PABLO DIVO CARRERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SA-C
Contact information
Practice address
820 NW 7TH AVE APT 208, MIAMI, FL 33136-3130
(954) 864-7509
Mailing address
820 NW 7TH AVE APT 208, MIAMI, FL 33136-3130
(954) 864-7509
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
20-514
FL
363A00000X
Physician Assistant
2877
PR
363AS0400X
Surgical Physician Assistant
2877
PR
Other
Enumeration date
12/22/2025
Last updated
12/22/2025
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