Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | ME31411 | FL |
NPI | 1477587814 |
---|---|
Provider Name | Gaston E Zilleruelo |
First Address | Miami, FL 33101-6960 |
Second Address | Miami, FL 33101-6960 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 19/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0384232-00 | (05) | FL |
95242 | (02) | FL |
D67411 | (02) | FL |