Provider Demographics
NPI:1427741651
Name:ARBOLAEZ HERNANDEZ, CHRISTIAN JESUS (SURGICAL ASSISTANT)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:JESUS
Last Name:ARBOLAEZ HERNANDEZ
Suffix:
Gender:M
Credentials:SURGICAL ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13939 SW 52ND LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-5184
Mailing Address - Country:US
Mailing Address - Phone:786-777-9149
Mailing Address - Fax:
Practice Address - Street 1:13939 SW 52ND LN
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-5184
Practice Address - Country:US
Practice Address - Phone:786-777-9149
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-01
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI23-385246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant