Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | ME117425 | FL |
Y | 2080P0205X | Pediatric Endocrinologist | ME117425 | FL |
NPI | 1063671212 |
---|---|
Provider Name | Miladys Miriam Palau Collazo |
First Address | Port Saint Lucie, FL 34987-2381 |
Second Address | Port Saint Lucie, FL 34987-2381 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2008 |
Last Update Date | 14/07/2021 |