Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | ME 0023253 | FL |
N | 207Q00000X | Family Doctor | ME 0023253 | FL |
Y | 207QA0401X | Family Doctor - Addiction Medicine | ME0023253 | FL |
N | 207RA0401X | Internist - Addiction Medicine | ME0023253 | FL |
NPI | 1164495057 |
---|---|
Provider Name | Dr. Dale Frank Syfert |
First Address | Gainesville, FL 32605-2826 |
Second Address | Gainesville, FL 32608 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2006 |
Last Update Date | 25/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C37774 | (02) |