Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | PO1744 | FL |
NPI | 1275638694 |
---|---|
Provider Name | Dr. Charlton Lance Adler |
First Address | North Miami Beach, FL 33179-4707 |
Second Address | North Miami Beach, FL 33179-4707 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2006 |
Last Update Date | 10/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
029767400 | (05) | FL |
T55618 | (02) | FL |