Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | PO-2600 | FL |
NPI | 1083670947 |
---|---|
Provider Name | Dr. Carmen O. Partridge |
First Address | N Miami Beach, FL 33179-4709 |
Second Address | N Miami Beach, FL 33179-4709 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2006 |
Last Update Date | 26/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
390330300 | (05) | FL |
U66451 | (02) | FL |