Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | ME85246 | FL |
NPI | 1073659934 |
---|---|
Provider Name | Deirdre J Atlas |
First Address | Bonita Springs, FL 34135-5801 |
Second Address | Bonita Springs, FL 34135-5801 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2007 |
Last Update Date | 29/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F88537 | (02) | FL |