Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | OS018419 | PA |
NPI | 1770825523 |
---|---|
Provider Name | Meghan Leigh Brooking |
First Address | Fort Lauderdale, FL 33309-3750 |
Second Address | Deerfield Beach, FL 33064-1370 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2013 |
Last Update Date | 12/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10346991470001 | (05) | PA |