TEDDY J DORIVAL

MIAMI, FL
NPI1417636549
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: PR  001732-P.A.)
Enumeration Date2023-07-17
Last Update Date2023-07-17
Business Address
TEDDY J DORIVAL
12600 NW 19TH AVE
MIAMI, FL 33167-2159
Phone number: 305-842-0171
Mailing Address
TEDDY J DORIVAL
PO BOX 380373
MIAMI, FL 33238-0373
Phone number: 305-842-0171
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