Individual
MISS MYLENE A MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1330 WEST AVE APT 1911, MIAMI BEACH, FL 33139-0908
(305) 604-8051
(305) 604-8051
Mailing address
1330 WEST AVE APT 1911, MIAMI BEACH, FL 33139-0908
(305) 604-8051
(305) 604-8051
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
16672
FL
Other
Enumeration date
08/28/2009
Last updated
09/06/2012
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