Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | ME126532 | FL |
N | 208000000X | Pediatrician | 126532 | FL |
N | 2080P0204X | Pediatric Emergency Doctor | ME126532 | FL |
NPI | 1548503394 |
---|---|
Provider Name | Jessica Cardona |
First Address | Miami, FL 33155-3009 |
Second Address | Miami, FL 33155 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2013 |
Last Update Date | 21/05/2018 |