Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 4723 | NM |
NPI | 1003359324 |
---|---|
Provider Name | Eunice Priya Jennifer Samuel |
First Address | Sunrise, FL 33323 |
Second Address | Sunrise, FL 33323-2869 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2016 |
Last Update Date | 18/11/2016 |