Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | DO6738 | FL |
N | 174N00000X | Lactation Consultant |
NPI | 1104472513 |
---|---|
Provider Name | Mrs. Latoya Appleton Kinsey |
First Address | Fort Lauderdale, FL 33312-1214 |
Second Address | Fort Lauderdale, FL 33312-1214 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2019 |
Last Update Date | 12/08/2019 |