Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | ME82957 | FL |
Y | 208200000X | Surgeon | ME82957 | FL |
Y | 208600000X | Surgeon | ME82957 | FL |
N | 2086S0120X | Pediatric Surgery | ME82957 | FL |
NPI | 1255353165 |
---|---|
Provider Name | Dr. Gennaro Selvaggi |
First Address | Miami, FL 33136-1005 |
Second Address | Miami, FL 33136-1005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 15/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2671492-00 | (05) | FL |
H91693 | (02) | FL |