Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | ME0036480 | FL |
NPI | 1184688962 |
---|---|
Provider Name | Dennis M Hale |
First Address | Bradenton, FL 34209 |
Second Address | Bradenton, FL 34209 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2006 |
Last Update Date | 21/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
160011830 | RAILROAD MEDICARE (01) | FL |
41171 | BCBS (01) | FL |
D54714 | (02) | FL |