Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | ME62312 | FL |
NPI | 1053383703 |
---|---|
Provider Name | Dr. Susana May |
First Address | Tavernier, FL 33070-0739 |
Second Address | Marathon, FL 33050-2784 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2006 |
Last Update Date | 24/04/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A92788 | (02) | FL |