Individual
EDIEL ENRIQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
5 CALLE BARBOSA, ISABELA, PR 00662-2956
(939) 313-0501
Mailing address
10450 SW 157TH CT APT 206, MIAMI, FL 33196-3649
(305) 710-4777
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
002512
PR
Other
Enumeration date
04/02/2025
Last updated
04/02/2025
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