Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | ME67058 | FL |
NPI | 1235167453 |
---|---|
Provider Name | Dr. Ann E David |
First Address | Sunrise, FL 33323-2865 |
Second Address | Pembroke Pines, FL 33028-1006 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 27/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
25944 | BLUE SHIELD (01) | FL |
376155000 | (05) | FL |
F89986 | (02) |