Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 60779 | TN |
Y | 2080P0214X | Pediatric Pulmonologist | 60779 | TN |
NPI | 1487089983 |
---|---|
Provider Name | Dr. Mariana Bedoya Pulgar Vidal |
First Address | Nashville, TN 37204-4701 |
Second Address | Nashville, TN 37232-1005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2013 |
Last Update Date | 25/03/2021 |