Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 11004413 | FL |
Y | 363LG0600X | Nurse Practitioner - Gerontology | ME11004413 | FL |
NPI | 1013559319 |
---|---|
Provider Name | Lourdes Mestre Valdes |
First Address | Miami Beach, FL 33140-2735 |
Second Address | Miami, FL 33136-1002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2019 |
Last Update Date | 03/12/2019 |