MIRIAN ANTELO COUCH

JACKSONVILLE, FL
NPI1881938991
Former NameMIRIAN ALICIAN ANTELO
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: FL  PA9106827)
Enumeration Date2012-11-15
Last Update Date2022-02-28
Business Address
MIRIAN ANTELO COUCH PA-C
6555 CHESTER AVE STE 1
JACKSONVILLE, FL 32217-2279
Phone number: 904-309-6504
Mailing Address
MIRIAN ANTELO COUCH PA-C
6555 CHESTER AVE STE 1
JACKSONVILLE, FL 32217-2279
Phone number: 904-265-8209
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