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Individual

MAYELIN SAN RAMOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3033 S MILITARY TRL LOT 30, LAKE WORTH, FL 33463-2107
(561) 386-3369
Mailing address
4575 SE DIXIE HWY, STUART, FL 34997-6826
(855) 832-6727

Taxonomy

Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
019142300
FL
Enumeration date
05/15/2017
Last updated
05/15/2017
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