Individual
DR. JOSE A LUIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
74 PHYSICIAN DR., AIKEN PEDIATRICS, P.A., AIKEN, SC 29801-6388
(803) 649-0578
(803) 649-2788
Mailing address
PO BOX 557367, MIAMI, FL 33255
(786) 624-5845
(786) 624-5881
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME34113
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
039493900
—
FL
Enumeration date
10/02/2006
Last updated
05/08/2009
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