Addison, Latonia Marie

Addison, Latonia Marie is an individual health care provider with primary practice located at 3601 Sw 160Th Ave Suite #250, Miramar FL 33027-6308. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Addison, Latonia Marie can be contacted via phone (305) 866-9951.

Contact Information

Primary practice address
3601 Sw 160Th Ave Suite #250 Miramar FL 33027-6308
Phone: (305) 866-9951
Fax: (877) 284-8933
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 057766 Georgia
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 057766 Georgia

Profile Details

NPI number 1962429605
LBN Legal business name Addison, Latonia Marie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 17th, 2006
Last updated Mar 2nd, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962429605 NPPES
Georgia MEDICAID 430738027A
Georgia Other P00811340

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