Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | A108900 | CA |
Y | 2080N0001X | Neonatal-Perinatal Doctor | ME118862 | FL |
NPI | 1114118478 |
---|---|
Provider Name | Dr. Edith Michelle Spencer-Morales |
First Address | Wellington, FL 33414-6103 |
Second Address | Wellington, FL 33414-6103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2007 |
Last Update Date | 05/07/2019 |