Individual
ODORICO PORFIRIO SANTO DOMINGO SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SA-C
Contact information
Practice address
506 E 44TH ST, HIALEAH, FL 33013-1914
(305) 794-7156
Mailing address
506 E 44TH ST, HIALEAH, FL 33013-1914
(305) 794-7156
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
24-136
FL
Other
Enumeration date
02/12/2024
Last updated
02/12/2024
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