Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | DN12532 | FL |
NPI | 1063536340 |
---|---|
Provider Name | Dr. Manal F Messiha |
First Address | Fort Lauderdale, FL 33315-2643 |
Second Address | Fort Lauderdale, FL 33315-2643 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2007 |
Last Update Date | 09/07/2007 |