Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | PO-0003037 | FL |
NPI | 1063501518 |
---|---|
Provider Name | Liana Korytowski Seldin |
First Address | Coral Gables, FL 33145-3409 |
Second Address | Coral Gables, FL 33145-3409 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 19/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
340494300 | (05) | FL |
V01090 | (02) | FL |