Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | OS0069 | FL |
NPI | 1235221045 |
---|---|
Provider Name | Anne Frailing |
First Address | Dunedin, FL 34698-6402 |
Second Address | Dunedin, FL 34698-6402 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2006 |
Last Update Date | 08/07/2007 |