Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | ME61848 | FL |
NPI | 1174549224 |
---|---|
Provider Name | Dr. Francisco J Civantos |
First Address | Miami, FL 33136 |
Second Address | Miami, FL 33136 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 05/03/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
17784 | (02) | FL |
3708055-00 | (05) | FL |
F02950 | (02) | FL |