Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | DN 16664 | FL |
NPI | 1154521888 |
---|---|
Provider Name | Dr. Nicole F Besu |
First Address | Coral Gables, FL 33134-3752 |
Second Address | Miami Lakes, FL 33016-1583 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2007 |
Last Update Date | 20/07/2007 |