Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | DN24959 | FL |
Y | 213EG0000X | General Practice | DN24959 | FL |
N | 1223P0700X | Prosthodontist | DN24959 | FL |
NPI | 1093244972 |
---|---|
Provider Name | David Rua Perez |
First Address | Naples, FL 34104-5256 |
Second Address | Naples, FL 34102-4806 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2017 |
Last Update Date | 02/03/2021 |