Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | OSO6806 | FL |
NPI | 1376591990 |
---|---|
Provider Name | Beatriz Behar |
First Address | Jupiter, FL 33477-7338 |
Second Address | Jupiter, FL 33477-7338 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F94188 | (02) | FL |