Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 12214 | FL |
NPI | 1811022858 |
---|---|
Provider Name | Dr. Ira Stone |
First Address | Hollywood, FL 33021-3552 |
Second Address | Hollywood, FL 33021-3552 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2007 |
Last Update Date | 04/04/2016 |