Individual
ALTAGRACITA CORNET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
16302 NW 14TH ST, PEMBROKE PINES, FL 33028-1313
(786) 320-0760
Mailing address
16302 NW 14TH ST, PEMBROKE PINES, FL 33028-1313
(786) 320-0760
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
11005233
FL
Other
Enumeration date
06/07/2021
Last updated
06/07/2021
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