Individual
DR. LUZDIVINA ANA VINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
301 FISHER ST, BILOXI, MS 39534-2508
(228) 376-0500
Mailing address
301 FISHER ST, BILOXI, MS 39534-2508
(228) 376-0500
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01074450A
IN
207P00000X
Emergency Medicine Physician
84846
GA
Other
Enumeration date
07/09/2012
Last updated
05/05/2020
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