Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | OS5329 | FL |
NPI | 1003912023 |
---|---|
Provider Name | Dr. Ileana Feuer |
First Address | Lake Worth, FL 33467-2903 |
Second Address | Lake Worth, FL 33461-3045 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2006 |
Last Update Date | 23/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
80345 | BCBS ID (01) | FL |
80345 | MEDICARE PTAN (01) | FL |
E53015 | (02) | FL |