Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | ME 92356 | FL |
N | 208600000X | Surgeon | ME 92356 | FL |
N | 2086S0129X | Vascular Surgeon | ME92356 | FL |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | ME92356 | FL |
NPI | 1134320880 |
---|---|
Provider Name | Dr. Efren Buitrago |
First Address | Doral, FL 33166-6658 |
Second Address | Doral, FL 33166-6658 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2007 |
Last Update Date | 25/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000215400 | (05) | FL |