Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | ME70544 | FL |
NPI | 1124015482 |
---|---|
Provider Name | Dr. Itzhak Nir |
First Address | Loxahatchee, FL 33470-9206 |
Second Address | Loxahatchee, FL 33470-9206 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2005 |
Last Update Date | 06/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
256013500 | (05) | FL |
G90966 | (02) | FL |