Doctor Name: | MARIA DE LOS ANGELES PUENTES |
NPI Number: | 1487839700 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 16919 N Bay Rd Apt 918 Sunny Isles Beach, FL - 331604220 |
Business Phone Number: | 7863337402 |
Business Fax Number: | 3059455134 |
Mailing Address: | 16919 N Bay Rd Apt 918, SUNNY ISLES BEACH |
State: | FL |
Postal Code: | 331604220 |
Phone Number: | 7863337402 |
Fax Number: | 3059455134 |
NPI Enumeration Date: | 01/05/2008 |
NPI Last Update Date: | 01/05/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 171000000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Military Health Care Provider |
Taxonomy Specialization: | |
Taxonomy Definition: | Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |