Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0203X | Pediatric Critical Care Doctor | 18848 | PR |
Y | 2080P0203X | Pediatric Critical Care Doctor | ME132269 | FL |
NPI | 1104107234 |
---|---|
Provider Name | Kristie Marye Rodriguez Otero |
First Address | Coral Gables, FL 33146-2423 |
Second Address | Coral Gables, FL 33146-2423 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2011 |
Last Update Date | 22/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
020915100 | (05) | FL |