Individual
NIXON JOANNY MONTILLA OLIVARES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SA-C
Contact information
Practice address
1541 E 6TH AVE, HIALEAH, FL 33010-3205
(305) 499-0122
Mailing address
1541 E 6TH AVE, HIALEAH, FL 33010-3205
(305) 499-0122
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
15-355
CO
Other
Enumeration date
07/16/2015
Last updated
07/16/2015
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