Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | ME89978 | FL |
Y | 207RX0202X | Medical Oncology | ME89978 | FL |
NPI | 1225034309 |
---|---|
Provider Name | Avram Jonathan Smukler |
First Address | Fort Myers, FL 33916-2216 |
Second Address | West Palm Beach, FL 33401-3406 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2005 |
Last Update Date | 20/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
270496000 | (05) | FL |
H26373 | (02) | FL |