Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | ME89129 | FL |
Y | 208600000X | Surgeon | ME89129 | FL |
N | 2082S0105X | Plastic Hand Surgeon | ME89129 | FL |
NPI | 1598839128 |
---|---|
Provider Name | Dr. Loretta M Coady-Fariborzian |
First Address | Orlando, FL 32891-8025 |
Second Address | Gainesville, FL 32610-3003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2006 |
Last Update Date | 29/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
278605200 | (05) | FL |