Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 125.063648 | IL |
Y | 207VX0201X | Gynecologic Oncologist | ME146171 | FL |
NPI | 1578805909 |
---|---|
Provider Name | Miss Adria Suarez Mora |
First Address | Weston, FL 33331-3609 |
Second Address | Weston, FL 33331-3625 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2013 |
Last Update Date | 10/02/2021 |