Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | ME101486 | FL |
NPI | 1003038555 |
---|---|
Provider Name | David Pascoe |
First Address | Tallahassee, FL 32308-4453 |
Second Address | Tallahassee, FL 32308-4453 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2007 |
Last Update Date | 20/06/2008 |