Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | ME87444 | FL |
Y | 208D00000X | General Practice Physician | ME87444 | FL |
NPI | 1033218821 |
---|---|
Provider Name | Arles Perdomo |
First Address | Naples, FL 34116-7670 |
Second Address | Naples, FL 34116-7670 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2006 |
Last Update Date | 31/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
262307200 | (05) | FL |