Individual
MR. JENRY URDANIVIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA42629
Contact information
Practice address
2980 SW 26TH ST, MIAMI, FL 33133-2118
(786) 271-1581
Mailing address
2980 SW 26TH ST, MIAMI, FL 33133-2118
(786) 271-1581
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
MA 42629
FL
Other
Enumeration date
02/02/2007
Last updated
07/08/2007
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