Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | PO2615 | FL |
Y | 222Z00000X | Podiatrist | PO2615 | FL |
NPI | 1043329733 |
---|---|
Provider Name | Dr. Nina L Coletta |
First Address | Plantation, FL 33324-2321 |
Second Address | Plantation, FL 33324-2321 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 06/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U68543 | (02) |