Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | ME 84115 | FL |
NPI | 1033277728 |
---|---|
Provider Name | Dr. Elisa M Brown-Soltero |
First Address | Tavernier, FL 33070-0460 |
Second Address | Tavernier, FL 33070-2506 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
263830400 | (05) | FL |
F64542 | (02) | FL |