Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 18294 | PR |
NPI | 1548814338 |
---|---|
Provider Name | Jose Fernando Arena |
First Address | Pinecrest, FL 33156-2952 |
Second Address | Pinecrest, FL 33156-2952 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2019 |
Last Update Date | 30/07/2019 |