Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0400X | Neurologist | 25MA09271100 | NJ |
Y | 2084N0400X | Neurologist | ME126337 | FL |
N | 2084N0600X | Clinical Neurophysiologist | D0073954 | MD |
NPI | 1003103706 |
---|---|
Provider Name | Dr. Enrico V Vintayen |
First Address | Bradenton, FL 34209-3201 |
Second Address | Punta Gorda, FL 33950-5520 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2011 |
Last Update Date | 25/07/2019 |