Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | DN0012377 | FL |
NPI | 1003834037 |
---|---|
Provider Name | Dr. Eduardo R Northland |
First Address | Coral Gables, FL 33145-3203 |
Second Address | Coral Gables, FL 33145-3203 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 08/07/2007 |