Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | DN 16906 | FL |
Y | 213EG0000X | General Practice | DN 16906 | FL |
NPI | 1003824145 |
---|---|
Provider Name | Natalie Koren |
First Address | Lighthouse Piont, FL 33064 |
Second Address | Lighthouse Point, FL 33064-6738 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2006 |
Last Update Date | 28/08/2007 |