Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | PO1940 | FL |
NPI | 1174588032 |
---|---|
Provider Name | Dr. Jason Randall Hanft |
First Address | South Miami, FL 33143-4716 |
Second Address | South Miami, FL 33143-4716 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U06268 | (02) | FL |