Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | ME 81958 | FL |
Y | 111NI0900X | Internist | ME 81958 | FL |
NPI | 1003241340 |
---|---|
Provider Name | Mira Baron |
First Address | West Palm Beach, FL 33409-3401 |
Second Address | West Palm Beach, FL 33409-3401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2013 |
Last Update Date | 05/09/2013 |