Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | ME91264 | FL |
Y | 207ND0101X | MOHS-Micrographic Surgeon | ME91264 | FL |
N | 207NS0135X | Procedural Dermatology | ME91264 | FL |
NPI | 1245216092 |
---|---|
Provider Name | Dr. David Brett Sable |
First Address | Tampa, FL 33611-1669 |
Second Address | Tampa, FL 33615-4518 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2005 |
Last Update Date | 22/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002193300 | (05) | FL |
H59271 | (02) |