Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207ND0101X | MOHS-Micrographic Surgeon | ME54696 | FL |
Y | 207ND0900X | Dermatopathologist | ME54696 | FL |
NPI | 1073518692 |
---|---|
Provider Name | Dr. Daniel Rivlin |
First Address | Miami Beach, FL 33140-2840 |
Second Address | Miami Beach, FL 33140-2840 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2005 |
Last Update Date | 04/11/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
376604700 | (05) | FL |
F48362 | (02) | FL |