Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | ME0082263 | FL |
NPI | 1073669909 |
---|---|
Provider Name | Dr. Joan Spinner Haynes |
First Address | Punta Gorda, FL 33950-1717 |
Second Address | N Ft Myers, FL 33903-3532 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2007 |
Last Update Date | 08/07/2007 |