Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 11008903 | FL |
NPI | 1023623493 |
---|---|
Provider Name | Laura Perez-Castillo |
First Address | Miami, FL 33157-2708 |
Second Address | Miami, FL 33157-2708 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2020 |
Last Update Date | 13/09/2020 |