Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | OS14734 | FL |
NPI | 1689092686 |
---|---|
Provider Name | Laura Stunja |
First Address | Jacksonville, FL 32256-0532 |
Second Address | Jacksonville, FL 32207-8426 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2014 |
Last Update Date | 28/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
024634800 | (05) | FL |