Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2082S0105X | Plastic Hand Surgeon | ME134928 | FL |
NPI | 1154689453 |
---|---|
Provider Name | Natalia Fullerton |
First Address | Miami, FL 33136-1119 |
Second Address | Miami, FL 33136-1119 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2012 |
Last Update Date | 16/10/2019 |