Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | OS8634 | FL |
NPI | 1043272115 |
---|---|
Provider Name | Dr. Jose Antonio Deolazabal |
First Address | Jupiter, FL 33458-2830 |
Second Address | Palm Beach Gardens, FL 33410-4325 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2006 |
Last Update Date | 11/03/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I35263 | (02) | FL |