Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist | COS705761 | CO |
NPI | 1013543701 |
---|---|
Provider Name | Kateau Cerisme |
First Address | Orlando, FL 32801-1624 |
Second Address | Orlando, FL 32801-1624 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2020 |
Last Update Date | 13/03/2020 |