Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | ME67040 | FL |
NPI | 1093700346 |
---|---|
Provider Name | Dr. Anthony James Hall |
First Address | Hollywood, FL 33023-4909 |
Second Address | Hollywood, FL 33023 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2005 |
Last Update Date | 18/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
140007991 | RAILROAD MEDICARE (01) | FL |
264899700 | (05) | FL |
G10843 | (02) | FL |