Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | MW302 | FL |
NPI | 1053717397 |
---|---|
Provider Name | Mercedes Escalante |
First Address | Homestead, FL 33032-5833 |
Second Address | Homestead, FL 33032-5833 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2014 |
Last Update Date | 14/11/2014 |