Individual
REBECA VALLEJO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2518 BIMINI LN, FORT LAUDERDALE, FL 33312-4750
(954) 579-4457
Mailing address
2518 BIMINI LN, FORT LAUDERDALE, FL 33312-4750
(954) 579-4457
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
18-484
FL
Other
Enumeration date
12/19/2018
Last updated
12/19/2018
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