Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156F00000X | Technician/Technologist | 5646 |
NPI | 1124658109 |
---|---|
Provider Name | Marlene Aranzola |
First Address | Homestead, FL 33032-8515 |
Second Address | Homestead, FL 33032-8515 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2020 |
Last Update Date | 18/01/2020 |