Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2081S0010X | Sports Medicine | PO3575 | FL |
N | 213ES0000X | Sports Medicine | PO3575 | FL |
Y | 213ES0103X | Foot & Ankle Surgery | PO3575 | FL |
N | 213ES0131X | Foot Surgery | PO3575 | FL |
NPI | 1225389620 |
---|---|
Provider Name | Dr. Brunilda Ducellari |
First Address | Miami, FL 33174 |
Second Address | Miami, FL 33174 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2012 |
Last Update Date | 15/07/2020 |