Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | ME139246 | FL |
NPI | 1003268707 |
---|---|
Provider Name | Amy Souers |
First Address | Orlando, FL 32806-8510 |
Second Address | Orlando, FL 32806-2008 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2016 |
Last Update Date | 20/06/2019 |