Provider Demographics
NPI:1043062888
Name:WALSH, EMILY ANN (MS)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:ANN
Last Name:WALSH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:344 MENDOZA AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33134-3854
Mailing Address - Country:US
Mailing Address - Phone:786-361-4144
Mailing Address - Fax:
Practice Address - Street 1:5665 PONCE DE LEON BLVD FL 5
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-2510
Practice Address - Country:US
Practice Address - Phone:786-361-4144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program