Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207T00000X | Neurosurgeon | 275307 | NY |
Y | 207T00000X | Neurosurgeon | ME123748 | FL |
NPI | 1013176734 |
---|---|
Provider Name | Dr. Constantine Elefterios Plakas |
First Address | Fort Myers, FL 33902-2147 |
Second Address | Fort Myers, FL 33901-5817 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2008 |
Last Update Date | 29/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
015035700 | (05) | FL |