Individual
MS. AUDREY ELAINE DERICHO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15131 TYLER ST, MIAMI, FL 33176-7644
(786) 205-5491
Mailing address
10905 SW 214TH ST APT 102, MIAMI, FL 33189-3093
(786) 205-5491
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
FL
Other
Enumeration date
08/14/2023
Last updated
08/14/2023
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