Individual
ED LARGAESPADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8180 DORAL BLVD, DORAL, FL 33166-6645
(305) 592-5225
Mailing address
8180 DORAL BLVD, DORAL, FL 33166-6645
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
BILLER
—
Other
Enumeration date
11/18/2017
Last updated
11/18/2017
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