Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | ME 106074 | FL |
NPI | 1881846731 |
---|---|
Provider Name | Dr. Anthony Bared |
First Address | South Miami, FL 33143-4870 |
Second Address | South Miami, FL 33143-4870 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/10/2008 |
Last Update Date | 10/09/2012 |