Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | ME149784 | FL |
NPI | 1023468600 |
---|---|
Provider Name | Dr. Fleta Bray |
First Address | Miami, FL 33136-1015 |
Second Address | Miami, FL 33136-1015 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2016 |
Last Update Date | 26/10/2021 |