Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | 225700000X | FL |
NPI | 1912161274 |
---|---|
Provider Name | Desiree Dorbad |
First Address | Juno Beach, FL 33408-1952 |
Second Address | Brandon, FL 33510-3012 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2008 |
Last Update Date | 16/07/2008 |