Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | DN20559 | FL |
N | 1223P0700X | Prosthodontist | DN20559 | FL |
NPI | 1245625342 |
---|---|
Provider Name | Maria A Magurno |
First Address | Weston, FL 33327-1805 |
Second Address | Davie, FL 33331 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2015 |
Last Update Date | 06/04/2015 |