Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | 5841 | FL |
Y | 213ES0000X | Sports Medicine | 5841 | FL |
NPI | 1174906457 |
---|---|
Provider Name | Marjorie Maye Soledad Mamsaang |
First Address | Miami, FL 33130-3579 |
Second Address | Coral Gables, FL 33133-2750 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2015 |
Last Update Date | 22/07/2021 |