Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | DO5542 | FL |
NPI | 1043305212 |
---|---|
Provider Name | Yanilei Marti |
First Address | Hialeah Gardens, FL 33016 |
Second Address | Miami, FL 33144 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 08/07/2007 |