Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | P02630 | FL |
Y | 222Z00000X | Podiatrist | P02630 | FL |
NPI | 1063462745 |
---|---|
Provider Name | Dr. Eric D Teeman |
First Address | Tampa, FL 33694-1873 |
Second Address | Lutz, FL 33549-5012 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2006 |
Last Update Date | 11/05/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
390410500 | (05) | FL |
U69076 | (02) |