Individual
YANIRA TIRADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3642 MOCA DR, SAINT CLOUD, FL 34772-8148
(407) 666-1129
(407) 483-9551
Mailing address
3642 MOCA DR, SAINT CLOUD, FL 34772-8148
(407) 666-1129
(407) 483-9551
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019555100
—
FL
Enumeration date
10/04/2018
Last updated
10/04/2018
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