Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | ME10538 | FL |
NPI | 1003811613 |
---|---|
Provider Name | Donald F Pitisci |
First Address | Tampa, FL 33609-1028 |
Second Address | Tampa, FL 33607-6326 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D21441 | (02) | FL |