Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | DO4364 | FL |
NPI | 1205248044 |
---|---|
Provider Name | Francisca Delagarza |
First Address | Saint Petersburg, FL 33714-3722 |
Second Address | Ruskin, FL 33573-6820 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2014 |
Last Update Date | 28/05/2014 |