Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | PR579 | FL |
Y | 222Z00000X | Podiatrist | PR579 | FL |
NPI | 1063999332 |
---|---|
Provider Name | Dr. Ashley Verceles |
First Address | Fontana, CA 92337-1401 |
Second Address | Hollywood, FL 33021-5421 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2018 |
Last Update Date | 19/07/2018 |