Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L94869 |
NPI | 1134691207 |
---|---|
Provider Name | Magalys S. Rezende |
First Address | Miami, FL 33176-4428 |
Second Address | Miami, FL 33176-4428 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2018 |
Last Update Date | 29/12/2018 |