Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | ME120365 | FL |
NPI | 1013150044 |
---|---|
Provider Name | Dr. Jonathan Guy Azoulai |
First Address | Gainesville, FL 32608-8003 |
Second Address | Miami, FL 33136-1003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2009 |
Last Update Date | 25/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1013150044 | (05) | FL |