Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | ME82364 | FL |
NPI | 1003885765 |
---|---|
Provider Name | Dr. Paula Michele Thaqi |
First Address | Fort Lauderdale, FL 33315-2643 |
Second Address | Fort Lauderdale, FL 33315-2643 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2006 |
Last Update Date | 06/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
37981 | BLUE CROSS PROVIDER NUMBE (01) | FL |
AI032Y | MEDICARE (01) | FL |