MEDICARE: MRS. MAGDALENA NORA URRA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246Z00000X	Other Specialist/Technologist	122383	FL

General Provider Information

NPI Number	:	1265693451
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MAGDALENA NORA URRA

Provider Business Mailing Address
First Line	:	7312 SW 139TH CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33183-3148
Country	:	US
Telephone Number	:	305-776-7296
Fax Number	:	305-408-3941

Provider Business Practice Location Address
First Line	:	7312 SW 139TH CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33183-3148
Country	:	US
Telephone Number	:	305-776-7296
Fax Number	:	305-408-3941

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2008
Last Update Date	:	06/19/2008

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