Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | ME 102635 | FL |
NPI | 1003174269 |
---|---|
Provider Name | Melanie Areopagita |
First Address | Hollywood, FL 33021-3457 |
Second Address | Hollywood, FL 33021-3457 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2012 |
Last Update Date | 16/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
006671900 | (05) | FL |