Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 0101-226152 | VA |
Y | 207N00000X | Dermatologist | ME81301 | FL |
NPI | 1013981364 |
---|---|
Provider Name | Anne K. Mcbride |
First Address | Fort Myers, FL 33908-5182 |
Second Address | Venice, FL 34292-4522 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2006 |
Last Update Date | 07/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
AI305V | MEDICARE PTAN (01) | FL |
F32336 | (02) |