Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | ME96694 | FL |
NPI | 1205920410 |
---|---|
Provider Name | Maureen Maciel |
First Address | Philadelphia, PA 19178-7642 |
Second Address | Tampa, FL 33612-9411 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 20/11/2012 |