Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | PO3964 | FL |
NPI | 1063866242 |
---|---|
Provider Name | Dr. Brian Asencio |
First Address | Miami, FL 33173-3441 |
Second Address | Miami, FL 33173 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2016 |
Last Update Date | 27/10/2020 |