Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | ME0012316 | FL |
NPI | 1023113636 |
---|---|
Provider Name | Arnold Erwin Ison |
First Address | St Pete Beach, FL 33706 |
Second Address | St Pete Beach, FL 33706-2223 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2006 |
Last Update Date | 24/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D58082 | (02) |