Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | P02402 | FL |
Y | 222Z00000X | Podiatrist | P02402 | FL |
N | 213E00000X | Podiatrist | PO2402 | FL |
N | 222Z00000X | Podiatrist | PO2402 | FL |
NPI | 1043211964 |
---|---|
Provider Name | Dr. Ann Marie Millar |
First Address | Miami, FL 33125 |
Second Address | Miami, FL 33125 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2005 |
Last Update Date | 13/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
390481400 | (05) | FL |
U515181 | (02) | FL |
U51581 | (02) |