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1154959971
JACOB CONVISSAR
MIAMI, FL
NPI
1154959971
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2020-03-28
Last Update Date
2020-04-06
Business Address
Dr. JACOB CONVISSAR DO
3100 SW 62ND AVE
MIAMI, FL 33155-3009
Phone number: 305-669-5873
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Mailing Address
Dr. JACOB CONVISSAR DO
3100 SW 62ND AVE
MIAMI, FL 33155-3009
Phone number: 305-669-5873
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