Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | ME75807 | FL |
N | 207YP0228X | Pediatric Otolaryngology | ME75807 | FL |
NPI | 1467452193 |
---|---|
Provider Name | Alberto De Dios Fernandez |
First Address | South Miami, FL 33143-3622 |
Second Address | South Miami, FL 33143-3622 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2005 |
Last Update Date | 20/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
260265200 | (05) | FL |
G69502 | (02) | FL |