Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | ME80860 | FL |
NPI | 1538112800 |
---|---|
Provider Name | Dr. Sandra Juanita Milan |
First Address | Immokalee, FL 34142-2200 |
Second Address | Immokalee, FL 34142-2200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 04/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
265322200 | (05) | FL |