Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | ME45566 | FL |
NPI | 1225252273 |
---|---|
Provider Name | Dr. Jay Bennett Peitzer |
First Address | Fort Lauderdale, FL 33309-6348 |
Second Address | Fort Lauderdale, FL 33309-6348 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D20850 | (02) | FL |