Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | DO1491 | FL |
NPI | 1104843994 |
---|---|
Provider Name | Teresa Jumet-Esteva |
First Address | Miami Lakes, FL 33014-2174 |
Second Address | Miami Lakes, FL 33014-2174 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2006 |
Last Update Date | 29/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
086853100 | (05) | FL |