Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 003955 | NY |
Y | 2080A0000X | Adolescent Medicine | ME142902 | FL |
NPI | 1215228895 |
---|---|
Provider Name | Elizabeth Carreno Rijo |
First Address | Orlando, FL 32806-1215 |
Second Address | Orlando, FL 32806-1215 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2011 |
Last Update Date | 22/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1215228895 | (05) | NY |