Provider Information for 1669839171
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Mr. GLENN CESAR PRIETO M.S.
Sex: Male
NPI: 1669839171
Last Updated: 2022-06-03
Certification Date: 2022-06-03
Certification Date: 2022-06-03
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1669839171 | ||||||||||||
| Enumeration Date | 2016-01-28 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 15997 SW 54TH TER MIAMI, FL 33185-5027 United States Phone: 305-439-9434 | Fax: | ||||||||||||
| Primary Practice Address | 15997 SW 54TH TER MIAMI, FL 33185-5027 United States Phone: 305-439-9434 | Fax: | ||||||||||||
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