Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | G88372 | CA |
Y | 207RC0000X | Internist - Cardiovascular Disease | ME147170 | FL |
NPI | 1013223064 |
---|---|
Provider Name | Luanda Grazette |
First Address | Miami, FL 33125-1659 |
Second Address | Miami, FL 33125-1659 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2010 |
Last Update Date | 29/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1902846306 | GROUP NPI (01) | CA |
GR0100430 | GROUP MEDICAL (01) | CA |
W18762 | GROUP MEDICARE (01) | CA |