Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | PY -6236 | FL |
NPI | 1508902313 |
---|---|
Provider Name | Mrs. Gladys Blanca Granda-Rodriguez |
First Address | Miami, FL 33137-4522 |
Second Address | Miami, FL 33137-4522 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2007 |
Last Update Date | 18/11/2010 |