Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | ME70790 | FL |
Y | 111NI0900X | Internist | ME70790 | FL |
N | 207RA0401X | Internist - Addiction Medicine | ME70790 | FL |
NPI | 1639179807 |
---|---|
Provider Name | Dr. Armando A De Feria |
First Address | Pembroke Pines, FL 33026-5207 |
Second Address | Pembroke Pines, FL 33026-5207 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2005 |
Last Update Date | 07/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
250941500 | (05) | FL |
G39317 | (02) | FL |