Individual
ANTONELLA FORMISANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2555 COLLINS AVE, MIAMI BEACH, FL 33140-4723
(305) 767-5905
Mailing address
2555 COLLINS AVE, MIAMI BEACH, FL 33140-4723
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
F652003956720
FL
Other
Enumeration date
01/09/2017
Last updated
01/09/2017
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