Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | ME41525 | FL |
NPI | 1063430254 |
---|---|
Provider Name | Anthony P Previte |
First Address | Fort Lauderdale, FL 33308-3725 |
Second Address | Fort Lauderdale, FL 33308-3725 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 25/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
068003699 | (05) | FL |
D27775 | (02) | FL |