Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | ME134120 | FL |
NPI | 1003255191 |
---|---|
Provider Name | Mary Antonette Maglalang Co |
First Address | Plantation, FL 33324-3923 |
Second Address | N Miami Beach, FL 33179 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2013 |
Last Update Date | 30/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
023344600 | (05) | FL |