Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | ME121146 | FL |
NPI | 1427341296 |
---|---|
Provider Name | Mariana Khawand-Azoulai |
First Address | Miami, FL 33136-1003 |
Second Address | Miami, FL 33136-1003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2011 |
Last Update Date | 18/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
016498100 | (05) | FL |