Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 11016115 | FL |
NPI | 1063175495 |
---|---|
Provider Name | Alejandro De La Flor |
First Address | Hialeah, FL 33016-4374 |
Second Address | Hialeah, FL 33016-4374 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2021 |
Last Update Date | 21/10/2021 |