Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VE0102X | Reproductive Endocrinologist | APRN11001067 | FL |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | APRN11001067 | FL |
NPI | 1245798800 |
---|---|
Provider Name | Sasha Granadillo |
First Address | Miami, FL 33177-0003 |
Second Address | South Miami, FL 33143-4800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2019 |
Last Update Date | 22/02/2021 |