Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | ME 102265 | FL |
NPI | 1003002817 |
---|---|
Provider Name | Nayvis Iglesias |
First Address | Doral, FL 33166-6658 |
Second Address | Doral, FL 33166-6658 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2007 |
Last Update Date | 09/02/2011 |