Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | ME102534 | FL |
Y | 111NI0900X | Internist | ME102534 | FL |
N | 207U00000X | Nuclear Medicine Specialist | ME102534 | FL |
NPI | 1699972984 |
---|---|
Provider Name | Dr. Hilton Rios De Souza Gomes |
First Address | Coral Gables, FL 33146 |
Second Address | Coral Gables, FL 33146 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2007 |
Last Update Date | 12/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
BY906X | (02) | FL |