Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | ME97337 | FL |
NPI | 1114185808 |
---|---|
Provider Name | Natalie Faith |
First Address | Zephyrhills, FL 33542-7505 |
Second Address | Zephyrhills, FL 33542-7505 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2008 |
Last Update Date | 25/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000302300 | (05) | FL |
P00717837 | RR MEDICARE (01) | FL |