Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | PO 2903 | FL |
Y | 222Z00000X | Podiatrist | PO 2903 | FL |
NPI | 1013960251 |
---|---|
Provider Name | Daniel Marc Hameroff |
First Address | Seminole, FL 33772-5423 |
Second Address | Seminole, FL 33772 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 05/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U84865 | (02) | FL |