Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | 5995 | FL |
NPI | 1114254489 |
---|---|
Provider Name | Dr. Carol Marie Cunningham |
First Address | Tallahassee, FL 32303-5807 |
Second Address | Tallahassee, FL 32303-5807 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2009 |
Last Update Date | 07/11/2009 |