Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | ME64921 | FL |
Y | 111NI0900X | Internist | ME64921 | FL |
N | 207RA0201X | Internist - Allergy & Immunology | ME64921 | FL |
NPI | 1811005457 |
---|---|
Provider Name | Gloria Farina |
First Address | Vero Beach, FL 32960-5690 |
Second Address | Vero Beach, FL 32960-5690 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2006 |
Last Update Date | 22/07/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D51837 | (02) | FL |