Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 1541 | FL |
NPI | 1154457489 |
---|---|
Provider Name | Mrs. Nuris Acosta Novoa |
First Address | Miami, FL 33185 |
Second Address | Miami, FL 33126 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2007 |
Last Update Date | 08/07/2007 |