Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | MW345 | FL |
NPI | 1114450558 |
---|---|
Provider Name | Margo Danielle Keane |
First Address | Vero Beach, FL 32968-2382 |
Second Address | Vero Beach, FL 32968-2382 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2017 |
Last Update Date | 04/04/2017 |