Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | ME136429 | FL |
NPI | 1093073645 |
---|---|
Provider Name | Abigail E Ley |
First Address | Loxahatchee, FL 33470-4938 |
Second Address | Port Saint Lucie, FL 34986 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2012 |
Last Update Date | 31/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
024943400 | (05) | FL |