Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | ME29080 | FL |
Y | 207V00000X | Obstetrician & Gynecologist | ME29080 | FL |
NPI | 1629031091 |
---|---|
Provider Name | Dennis Anthony Niner |
First Address | Brooksville, FL 34601-2518 |
Second Address | Brooksville, FL 34601-2518 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2006 |
Last Update Date | 17/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
259403000 | (05) | FL |
D60479 | (02) | FL |