Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | ME49248 | FL |
NPI | 1609985605 |
---|---|
Provider Name | Dr. Jeffrey Devon |
First Address | Boca Raton, FL 33486-2346 |
Second Address | Boca Raton, FL 33486-2346 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 15/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B87036 | (02) | FL |