Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | ME73050 | FL |
NPI | 1043233646 |
---|---|
Provider Name | Dr. Dibe Martin |
First Address | Miami, FL 33143 |
Second Address | Miami, FL 33143 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 16/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
252425200 | (05) | FL |
F88830 | (02) |