Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | ME101461 | FL |
NPI | 1003082967 |
---|---|
Provider Name | Janka Katancikova Baiza |
First Address | Boynton Beach, FL 33437-3760 |
Second Address | Doral, FL 33166-6554 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2008 |
Last Update Date | 13/10/2020 |