Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 31425 | FL |
N | 111NX0100X | Occupational Health | 31425 | FL |
NPI | 1447570965 |
---|---|
Provider Name | Roslyn H Shirdel |
First Address | Davie, FL 33325-3243 |
Second Address | Davie, FL 33325-3243 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2010 |
Last Update Date | 07/06/2010 |