Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | ME60830 | FL |
NPI | 1114955390 |
---|---|
Provider Name | Dr. Jose R Garrote |
First Address | Sunrise, FL 33323-2865 |
Second Address | Pembroke Pines, FL 33028-1006 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 14/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
23607 | BLUE SHIELD (01) | FL |
373850700 | (05) | FL |
F70142 | (02) |