Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | OS 10826 | FL |
NPI | 1174732705 |
---|---|
Provider Name | Dr. Jose F Llach JR. |
First Address | Miami, FL 33186-2815 |
Second Address | Miami, FL 33186 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2007 |
Last Update Date | 24/01/2020 |