Individual
VANESSA PERDOMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A
Contact information
Practice address
11826 SW154 COURT, MIAMI, FL 33196
(786) 553-1441
Mailing address
11826 SW 154 COURT, MIAMI, FL 33196-1090
(786) 553-1441
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9106239
FL
Other
Enumeration date
02/07/2012
Last updated
05/15/2015
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