Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 136258 | FL |
NPI | 1609259993 |
---|---|
Provider Name | Maria Raquel Schonenberg Llach |
First Address | Jacksonville, FL 32209-6511 |
Second Address | Jacksonville, FL 32209 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2015 |
Last Update Date | 19/10/2019 |