Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | ME109747 | FL |
NPI | 1003067612 |
---|---|
Provider Name | Dr. Michelle Norden |
First Address | Lk. Mary, FL 32746 |
Second Address | Lk. Mary, FL 32746 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2008 |
Last Update Date | 21/12/2011 |