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1386603462
MANUEL DEJESUS BACALLAO
MIAMI, FL
NPI
1386603462
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: FL ME38837)
Enumeration Date
2006-03-20
Last Update Date
2010-08-03
Business Address
Mr. MANUEL DEJESUS BACALLAO MD
8525 SW 92 STREET SUITE B 4
MIAMI, FL 33156-7374
Phone number: 305-279-7446
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Mailing Address
Mr. MANUEL DEJESUS BACALLAO MD
8525 SW 92 STREET SUITE B 4
MIAMI, FL 33156-7374
Phone number: 305-279-7446
Copy
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