Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | DH25656 | FL |
NPI | 1063921096 |
---|---|
Provider Name | Karen Ferrera |
First Address | Immokalee, FL 34142-2200 |
Second Address | Naples, FL 34103-3594 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2017 |
Last Update Date | 21/09/2017 |