Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | ME62593 | FL |
Y | 2080P0214X | Pediatric Pulmonologist | ME62593 | FL |
NPI | 1164531927 |
---|---|
Provider Name | Dr. Floyd R. Livingston JR. |
First Address | Rockland, DE 19732-0191 |
Second Address | Orlando, FL 32806-2944 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 15/01/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
370872100 | (05) | FL |
E50403 | (02) |