Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | ME124264 | FL |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | ME124264 | FL |
NPI | 1043414410 |
---|---|
Provider Name | Dr. Mirylsa Colon-Martinez |
First Address | Boca Raton, FL 33428-2236 |
Second Address | Boca Raton, FL 33428 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2007 |
Last Update Date | 23/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
015543400 | (05) | FL |