Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | DN21244 | FL |
NPI | 1003298522 |
---|---|
Provider Name | Milagritos Rios Ku Hop |
First Address | Doral, FL 33178-2358 |
Second Address | Doral, FL 33178-2358 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2015 |
Last Update Date | 20/06/2015 |