Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 11010649 | FL |
NPI | 1023604022 |
---|---|
Provider Name | Mr. Ernesto L Sarduy |
First Address | Miami, FL 33193-2928 |
Second Address | Miami, FL 33193-2928 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2020 |
Last Update Date | 15/12/2020 |