Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | OS7043 | FL |
NPI | 1043218233 |
---|---|
Provider Name | Anthony Sancetta |
First Address | Ocala, FL 34471 |
Second Address | Ocala, FL 34471 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2005 |
Last Update Date | 29/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
57179T | MEDICARE PTAN (01) | FL |
G11795 | (02) |