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1023290269
JOHAN MENNIG SAN ROMAN
HOMESTEAD, FL
NPI
1023290269
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: FL PA3409)
Enumeration Date
2007-11-29
Last Update Date
2007-11-29
Business Address
Mr. JOHAN MENNIG SAN ROMAN PA-C
975 BAPTIST WAY
HOMESTEAD, FL 33033-7600
Phone number: 305-793-4706
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Mailing Address
Mr. JOHAN MENNIG SAN ROMAN PA-C
6634 SW 114TH PL UNIT A
MIAMI, FL 33173-1783
Phone number: 305-793-4706
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