Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | CO107 | FL |
Y | 222Z00000X | Podiatrist | CO107 | FL |
NPI | 1023420338 |
---|---|
Provider Name | Mrs. Jane E. Marlor |
First Address | Orlando, FL 32804-4639 |
Second Address | Orlando, FL 32804-4639 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2014 |
Last Update Date | 21/05/2014 |