Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | ARNP9335476 | FL |
NPI | 1003308685 |
---|---|
Provider Name | Jose R Jiron |
First Address | Miami, FL 33184-2513 |
Second Address | Miami, FL 33125-1659 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2018 |
Last Update Date | 10/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
ARNP9335476 | STATE OF FLORIDA (01) | FL |