Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TH0100X | Health Service |
NPI | 1467029645 |
---|---|
Provider Name | Ms. Sara Luque Casado |
First Address | Miami, FL 33130-3610 |
Second Address | Miami, FL 33186-7510 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2021 |
Last Update Date | 07/06/2021 |