Individual
ABRAHAM DE JESUS VIVES-AMOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1038 W 79TH ST, HIALEAH, FL 33014-3586
(786) 391-8695
Mailing address
1038 W 79TH ST, HIALEAH, FL 33014-3586
(786) 391-8695
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
240156
FL
Other
Enumeration date
07/16/2024
Last updated
07/16/2024
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