Organization
JNISSI SIGNATURE COLLECTION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VENECIA LASALLE JEAN (CRANIAL PROSTHESIS SPECILAIST)
(786) 617-2606
Entity
Organization
Contact information
Practice address
435 NE 171ST TER, NORTH MIAMI BEACH, FL 33162-3914
(786) 617-2606
Mailing address
435 NE 171ST TER, NORTH MIAMI BEACH, FL 33162-3914
(786) 617-2606
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
09/13/2016
Last updated
09/13/2016
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