Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 218931 | NY |
Y | 2084N0400X | Neurologist | 218931 | NY |
NPI | 1013901263 |
---|---|
Provider Name | Dr. Kelly Maureen Maton |
First Address | Miami, FL 33155-4071 |
Second Address | Palmetto Bay, FL 33157-5636 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2005 |
Last Update Date | 27/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02097661 | (05) | NY |
H08211 | (02) | NY |