Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | DN16400 | FL |
NPI | 1003826538 |
---|---|
Provider Name | Ms. Valerie J. V. Minor |
First Address | Fernandina Beach, FL 32034-4544 |
Second Address | Jacksonville, FL 32218-4601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 08/07/2007 |