Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | ME77977 | FL |
NPI | 1215958665 |
---|---|
Provider Name | Dr. Emmanuel Mercado Cleto JR. |
First Address | Orlando, FL 32803-8208 |
Second Address | Orlando, FL 32803-8208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2006 |
Last Update Date | 08/07/2007 |