Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1100X | Ophthalmic |
NPI | 1477055564 |
---|---|
Provider Name | Marina Nemiroff |
First Address | Stuart, FL 34996-6338 |
Second Address | Stuart, FL 34996-6338 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2018 |
Last Update Date | 05/03/2018 |