Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208800000X | Urologist | D62856 | MD |
N | 208800000X | Urologist | M3052 | TX |
Y | 208800000X | Urologist | ME108495 | FL |
NPI | 1053365767 |
---|---|
Provider Name | Albert Michael Ong |
First Address | Orlando, FL 32806-2942 |
Second Address | Orlando, FL 32806-2942 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 29/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
178480301 | (05) | TX |
408016500 | (05) | MD |
EK763Z | (02) | FL |
I35863 | (02) | MD |