Individual
BIANCA VISAN SURITA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1611 NW 12TH AVE, MIAMI, FL 33136-1005
(305) 585-5437
Mailing address
9101 SW 212TH TER, CUTLER BAY, FL 33189-3871
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
9578755
FL
Other
Enumeration date
04/16/2021
Last updated
10/25/2021
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