Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0203X | Pediatric Critical Care Doctor | 9112532 | FL |
NPI | 1114578853 |
---|---|
Provider Name | Erica Leah Stoller |
First Address | Hallandale Beach, FL 33009-4488 |
Second Address | Hollywood, FL 33021-5421 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2019 |
Last Update Date | 01/04/2021 |