Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | ME73811 | FL |
NPI | 1033270251 |
---|---|
Provider Name | Dr. Carlos Ernesto Spera |
First Address | Davie, FL 33330-4302 |
Second Address | Davie, FL 33330-4302 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2006 |
Last Update Date | 25/08/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G79137 | (02) | FL |