Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | ME96350 | FL |
NPI | 1013118405 |
---|---|
Provider Name | Dr. Juan Carlos Brenes |
First Address | Miramar, FL 33025-3925 |
Second Address | Hollywood, FL 33021-5431 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2007 |
Last Update Date | 15/03/2021 |