Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | ME82654 | FL |
NPI | 1013909928 |
---|---|
Provider Name | Anna E Nogales |
First Address | Tampa, FL 33607-6308 |
Second Address | Tampa, FL 33607-6308 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G52239 | (02) | FL |