Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | ME127373 | FL |
Y | 207QG0300X | Family Doctor - Geriatric Medicine | ME127373 | FL |
NPI | 1265899702 |
---|---|
Provider Name | Karen V Sierra |
First Address | Weston, FL 33331-3502 |
Second Address | Weston, FL 33331-3502 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2016 |
Last Update Date | 17/03/2018 |