Individual
JESUS SALVADOR RODRIGUEZ REQUENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SA-C525
Contact information
Practice address
8814 W FLAGLER ST APT 207, MIAMI, FL 33174-3946
(305) 497-3036
Mailing address
8814 W FLAGLER ST APT 207, MIAMI, FL 33174-3946
(305) 497-3036
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
R362437644660
FL
Other
Enumeration date
09/22/2017
Last updated
09/22/2017
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