Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | ARNP9234017 | FL |
NPI | 1003207887 |
---|---|
Provider Name | Mr. Noel Medina Rojo |
First Address | Miami, FL 33175-2453 |
Second Address | Miami, FL 33175-2453 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2015 |
Last Update Date | 14/02/2015 |