Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 2015013313 | MO |
N | 2080P0205X | Pediatric Endocrinologist | 2015013313 | MO |
Y | 2080P0205X | Pediatric Endocrinologist | ME150153 | FL |
NPI | 1073830204 |
---|---|
Provider Name | Dr. Andrea Granados |
First Address | Miami, FL 33155-3009 |
Second Address | Miami, FL 33155-3009 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2010 |
Last Update Date | 29/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
ENROLLED | (05) | IL |