Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | ME135556 | FL |
N | 2080A0000X | Adolescent Medicine | ME135556 | FL |
NPI | 1245477231 |
---|---|
Provider Name | Maria Roberta Moro |
First Address | Miami, FL 33173-3287 |
Second Address | Miami, FL 33173 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/01/2009 |
Last Update Date | 31/05/2018 |