Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 55115 | FL |
NPI | 1063467983 |
---|---|
Provider Name | Dr. Sonia Michael |
First Address | Miami, FL 33175-3575 |
Second Address | Miami, FL 33175-3575 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2006 |
Last Update Date | 17/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
BM1390727 | DEA (01) | FL |
F40239 | (02) | FL |
ME0055115 | MEDICAL LICENSE (01) | FL |