Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | PO 0001527 | FL |
NPI | 1114026929 |
---|---|
Provider Name | Dr. Dennis Robert Frisch |
First Address | Boca Raton, FL 33431-6401 |
Second Address | Boca Raton, FL 33432-6134 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2006 |
Last Update Date | 20/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
PO0001527 | LICENSE NUMBER (01) | FL |