Individual
JUAN ENCISO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
169 ASHLEY AVE RM 202, CHARLESTON, SC 29425-3438
(843) 876-4794
Mailing address
169 ASHLEY AVE RM 202, CHARLESTON, SC 29425-8905
(843) 876-4794
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
OS19909
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2020
Last updated
04/22/2024
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