Provider Demographics
NPI:1548959695
Name:ETAYEM, LAYALI (LM)
Entity type:Individual
Prefix:
First Name:LAYALI
Middle Name:
Last Name:ETAYEM
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12310 NW 52ND CT
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33076-3451
Mailing Address - Country:US
Mailing Address - Phone:954-410-5188
Mailing Address - Fax:
Practice Address - Street 1:12310 NW 52ND CT
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33076-3451
Practice Address - Country:US
Practice Address - Phone:954-410-5188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMW443175M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay