Individual
MISS NASTASIA DE LAMAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13740 NW 19TH AVE, BAY 16, OPA LOCKA, FL 33054-4211
(305) 915-9666
Mailing address
13740 NW 19TH AVE, BAY 16, OPA LOCKA, FL 33054
(305) 915-9666
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
—
—
Other
Enumeration date
01/30/2014
Last updated
01/30/2014
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