Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | ME78553 | FL |
NPI | 1053396150 |
---|---|
Provider Name | Dr. Jonette Elizabeth Keri |
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 | 12/12/2005 |
Last Update Date | 13/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2594242-00 | (05) | FL |
H19074 | (02) | FL |