Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1100X | Ophthalmic |
NPI | 1134767668 |
---|---|
Provider Name | Marlene Reda |
First Address | Miami, FL 33135-2755 |
Second Address | Miami, FL 33135-2755 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/12/2019 |
Last Update Date | 16/12/2019 |