Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | DO1167 | FL |
NPI | 1215104765 |
---|---|
Provider Name | Mrs. Julia Dube Brezina |
First Address | Miami, FL 33155-4069 |
Second Address | Miami, FL 33155-4069 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2008 |
Last Update Date | 14/05/2008 |