Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | ME47186 | FL |
NPI | 1275597973 |
---|---|
Provider Name | Eysa M. Marquez-Brito |
First Address | Coral Gables, FL 33134-4515 |
Second Address | Coral Gables, FL 33134-6000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2006 |
Last Update Date | 22/12/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E15786 | (02) | FL |