Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 009939 | FL |
Y | 213EG0000X | General Practice | 009939 | FL |
NPI | 1003133778 |
---|---|
Provider Name | Beatriz Davidson |
First Address | Miami, FL 33176-5814 |
Second Address | Miami, FL 33176-5814 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2010 |
Last Update Date | 21/04/2010 |