Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | DO1438 | FL |
NPI | 1164685400 |
---|---|
Provider Name | Maria Elena Otero |
First Address | Miami, FL 33144-2923 |
Second Address | Miami, FL 33144-2923 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2008 |
Last Update Date | 07/07/2008 |