Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | PO1183 | FL |
Y | 222Z00000X | Podiatrist | PO1183 | FL |
NPI | 1043552755 |
---|---|
Provider Name | Dr. Edward N Geller |
First Address | Hialeah, FL 33014-5154 |
Second Address | Hialeah, FL 33014-5154 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2013 |
Last Update Date | 20/03/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
390009600 | (05) | FL |