Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | ME141547 | FL |
NPI | 1073931903 |
---|---|
Provider Name | Jovanna Bertran-Lopez |
First Address | Miami, FL 33136-1003 |
Second Address | Miami, FL 33136-1003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2014 |
Last Update Date | 09/09/2019 |