Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | OS8232 | FL |
NPI | 1245285469 |
---|---|
Provider Name | Ellen Wood |
First Address | South Miami, FL 33143-4806 |
Second Address | South Miami, FL 33143-4806 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G48334 | (02) | FL |