Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | ME140290 | FL |
NPI | 1003293523 |
---|---|
Provider Name | Angel Tabuyo-Martin |
First Address | Miami, FL 33136-1002 |
Second Address | Miami, FL 33136-1002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2015 |
Last Update Date | 22/05/2019 |