Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | 00000000000 | FL |
NPI | 1952506412 |
---|---|
Provider Name | Elvis Lazaro Ferrera |
First Address | Hialeah, FL 33012-4309 |
Second Address | Hialeah, FL 33010-3159 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2007 |
Last Update Date | 08/07/2007 |