Individual
LEONCIO EMILIO MONCADA MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SA-C
Contact information
Practice address
8870 NW 103RD AVE, DORAL, FL 33178-3290
(786) 757-8828
Mailing address
8870 NW 103RD AVE, DORAL, FL 33178-3290
(786) 757-8828
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
14-154
FL
Other
Enumeration date
04/18/2019
Last updated
04/18/2019
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