Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | ME 59113 | FL |
Y | 111NI0900X | Internist | ME 59113 | FL |
NPI | 1003803958 |
---|---|
Provider Name | Dr. Dennis Fox |
First Address | Inverness, FL 34451-0605 |
Second Address | Inverness, FL 34452-0605 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2005 |
Last Update Date | 10/01/2014 |