Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213ES0103X | Foot & Ankle Surgery | 006555 | NY |
Y | 213ES0103X | Foot & Ankle Surgery | PO3648 | FL |
NPI | 1104116631 |
---|---|
Provider Name | Dr. Jennifer Melissa Lee Fox |
First Address | Inverness, FL 34452-4819 |
Second Address | Inverness, FL 34452-4819 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2011 |
Last Update Date | 29/10/2014 |