Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 11729 | FL |
NPI | 1194758078 |
---|---|
Provider Name | Dr. Constantine Nicholas Kitsos |
First Address | Miami, FL 33138 |
Second Address | Miami, FL 33138 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D59828 | (02) |