Individual provider · NPI-1

Luis Enrique Avila Moreno, Surgical Assistant

Specialist/Technologist, Other, Surgical Assistant · Hialeah, FL

NPI number1942900402
StatusActive
Last updated in NPPESMar 3, 2023

Details

NPI
1942900402
Entity type
Individual (NPI-1)
Name
Mr. Luis Enrique Avila Moreno
Credential
Surgical Assistant
Sex
Male
Sole proprietor
Yes
Enumeration date
Mar 3, 2023
Certification date
Jan 9, 2021
Last updated
Mar 3, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
246ZC0007X Specialist/Technologist, Other, Surgical Assistant20-527FLYes

Practice location

2140 W 68th St Ste 200
Hialeah, FL 33016-1815

Phone 305-822-7227 · Fax 305-827-6333

Mailing address

1870 Mariners Ln
Weston, FL 33327-1334

Phone 786-461-4428

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