Individual
MANUAL DEARRIBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSA
Contact information
Practice address
3663 S MIAMI AVE, MIAMI, FL 33133-4253
(305) 854-4400
Mailing address
3 MARYLAND FARMS STE 200, BRENTWOOD, TN 37027-5780
(800) 348-4565
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
22-785
FL
Other
Enumeration date
10/18/2024
Last updated
10/18/2024
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