Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | ME96589 | FL |
Y | 207ND0101X | MOHS-Micrographic Surgeon | ME96589 | FL |
N | 207NS0135X | Procedural Dermatology | ME96589 | FL |
NPI | 1427164466 |
---|---|
Provider Name | Dr. Andrew Peter Kontos |
First Address | Naples, FL 34110 |
Second Address | Ft Myers, FL 33908 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2006 |
Last Update Date | 08/08/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I66543 | (02) |