Graduated: 2016
NPI: 1710794219
Practice Locations (3)
16210 PEBBLEBROOK DR
TAMPA, FL 336241025
1519 AVE PONCE DE LEON, SUITE 1105
SAN JUAN, PR 00909
1519 AVE PONCE DE LEON, SUITE 1105
SAN JUAN, PR 009091722
8138501427
Source: CMS National Downloadable File, September 2026.