Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | ME73196 | FL |
NPI | 1215964655 |
---|---|
Provider Name | Dr. Jerome Haym |
First Address | Delray Beach, FL 33483-6829 |
Second Address | Riviera Beach, FL 33410-7417 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
VADOO | (02) | FL |