Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | ME117954 | FL |
Y | 208600000X | Surgeon | ME117954 | FL |
N | 2086S0102X | Surgical Critical Care | 25MA06117800 | NJ |
NPI | 1225127079 |
---|---|
Provider Name | Alicia M. Mohr |
First Address | Gainesville, FL 32610-0108 |
Second Address | Gainesville, FL 32610-3001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 13/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010304800 | (05) | FL |
8237409 | (05) | NJ |
H17047 | (02) | NJ |