Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NN1001X | Nutrition | CH7012 | FL |
N | 175F00000X | Naturopath | NAT1000707 | DC |
NPI | 1194835900 |
---|---|
Provider Name | Dr. Emmanuel O Junard |
First Address | Miami Gardens, FL 33169-4008 |
Second Address | Miami Gardens, FL 33169-4008 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U57469 | (02) | FL |