Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | ME123197 | FL |
N | 208000000X | Pediatrician | ME123197 | FL |
NPI | 1639435498 |
---|---|
Provider Name | Dr. Stephanie Ann Melbourne-Carbs |
First Address | Miami, FL 33165-3311 |
Second Address | Miami, FL 33165 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2012 |
Last Update Date | 14/06/2018 |