Most Relevant Information
Provider Data
| NPI Number: | 1003331745 |
| Provider Name: | MARIELA FUENTES |
| Entity Type: | Individual |
| Taxonomy Code: | 2355S0801X |
| Specialty: | Specialist/Technologist |
| License Number: | SI2424 |
Most Important Dates
| Enumeration Date: | 08/03/2017 |
| Last Updated: | 06/16/2018 |
Provider Practice Location
8415 SW 24TH ST STE 205
MIAMI
FL
331552305
Practice Location Phone/Fax
| Phone: | 3052626868 |
| Fax: |
Provider Mailing Location
13768 SW 157 ST
MIAMI
FL
33177
Provider Mailing Phone/Fax
| Phone: | 3053008705 |
| Fax: |