Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | ME88781 | FL |
NPI | 1003030347 |
---|---|
Provider Name | Dr. Eric Belizaire |
First Address | Lauderdale Lakes, FL 33313-3772 |
Second Address | Lauderdale Lakes, FL 33313-3772 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2007 |
Last Update Date | 08/07/2007 |