Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | ME 9619 | FL |
NPI | 1548206675 |
---|---|
Provider Name | Daniel N Tucker |
First Address | West Palm Beach, FL 33401-3404 |
Second Address | West Palm Beach, FL 33401-3404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2006 |
Last Update Date | 07/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D21667 | (02) | FL |