Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | ME73730 | FL |
NPI | 1215926415 |
---|---|
Provider Name | Dr. Hua Fang-Patrick |
First Address | Miramar, FL 33029-5593 |
Second Address | Miramar, FL 33029-5593 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2005 |
Last Update Date | 31/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I39027 | (02) |