KRISTIAN RAFAEL HENRIQUEZ MIRANDONA

ANGOLA, IN
NPI1245671585
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207R00000X Internal Medicine
(Licence: IN  01080797A)
Enumeration Date2013-07-15
Last Update Date2018-09-10
Business Address
KRISTIAN RAFAEL HENRIQUEZ MIRANDONA M.D
416 E MAUMEE ST
ANGOLA, IN 46703-2015
Phone number: 260-344-4035
Mailing Address
KRISTIAN RAFAEL HENRIQUEZ MIRANDONA M.D
6435 W JEFFERSON BLVD PMB 109
FORT WAYNE, IN 46804-6203
Phone number: 260-344-4035