Individual
MARILUZ TERESA PROENZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12326 SW 124TH PATH, MIAMI, FL 33186-5482
(305) 934-3164
Mailing address
12326 SW 124TH PATH, MIAMI, FL 33186-5482
(305) 934-3164
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
16-660
WI
Other
Enumeration date
10/29/2016
Last updated
10/29/2016
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