Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | ME91201 | FL |
NPI | 1003815143 |
---|---|
Provider Name | Darlene Marie Eckert |
First Address | Orlando, FL 32837-6199 |
Second Address | Orlando, FL 32837-6199 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2005 |
Last Update Date | 17/07/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01SS3 | (02) | |
270651200 | (05) | FL |