Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | MW167 | FL |
NPI | 1104056225 |
---|---|
Provider Name | Mrs. Miriam Pearson-Martinez |
First Address | Delray Beach, FL 33444 |
Second Address | Delray Beach, FL 33444 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2009 |
Last Update Date | 20/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
340429300 | (05) | FL |