Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | ME125151 | FL |
NPI | 1053575050 |
---|---|
Provider Name | Dr. Magaly Villafradez-Diaz |
First Address | Kissimmee, FL 34741-4113 |
Second Address | Melbourne, FL 32901-3183 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2008 |
Last Update Date | 06/07/2020 |