Individual
MS. VIVIAN FENNEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4175 W 20TH AVE, HIALEAH, FL 33012-5874
(305) 825-0300
Mailing address
12242 SW 124TH PATH, MIAMI, FL 33186-5481
(305) 278-7565
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/19/2007
Last updated
07/08/2007
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