Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 099.0134091 | VT |
N | 175L00000X | Homeopath |
NPI | 1225521073 |
---|---|
Provider Name | Dr. Ramona Shires |
First Address | Pensacola, FL 32503-7230 |
Second Address | Pensacola, FL 32504-5032 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2018 |
Last Update Date | 07/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
099.0134091 | NATUROPATHIC PHYSICIAN (01) | VT |
ND9613 | LICENSED DIETITIAN NUTRITIONIST (01) | FL |