Individual
MISS KATHY ANN MORMAN I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12750 NW 27TH AVE APT 27TH, OPA- LOCKA, FL 33054-7027
(786) 970-8485
Mailing address
12750 NW 27TH AVE APT 27TH, OPA LOCKA, FL 33054-7027
(786) 970-8485
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
003938000
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003938000
—
FL
Enumeration date
04/12/2012
Last updated
04/12/2012
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