Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | ME122255 | FL |
N | 2080P0205X | Pediatric Endocrinologist | ME122255 | FL |
NPI | 1225270663 |
---|---|
Provider Name | Dr. Lital Reitblat |
First Address | Miramar, FL 33025-3925 |
Second Address | Hollywood, FL 33021 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2009 |
Last Update Date | 16/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
015269200 | (05) | FL |
1513U | FL BLUE (01) | FL |