Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OPC 3390 | FL |
NPI | 1003096421 |
---|---|
Provider Name | Dr. Lianne M. Pino-Etten |
First Address | Village Of Palmetto Bay, FL 33157-1981 |
Second Address | Village Of Palmetto Bay, FL 33157-1981 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2007 |
Last Update Date | 15/09/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U79778 | (02) | FL |