Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | L2389 | TX |
NPI | 1033184197 |
---|---|
Provider Name | Theresa A. Kuforiji |
First Address | Hollywood, FL 33081-0209 |
Second Address | Sunrise, FL 33323-2853 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8B4444 | BCBS (01) | TX |