Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | 20077 | FL |
N | 213EG0000X | General Practice | 20077 | FL |
Y | 1223P0700X | Prosthodontist | 20077 | FL |
NPI | 1104266402 |
---|---|
Provider Name | Dr. Ambar Desiree Pagani |
First Address | Sunny Isles Beach, FL 33160-2478 |
Second Address | North Miami, FL 33181-2902 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2013 |
Last Update Date | 01/07/2013 |