Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 12888 | FL |
NPI | 1013202233 |
---|---|
Provider Name | Dr. Justin James Mcnamee |
First Address | New Smyrna Beach, FL 32169-5402 |
Second Address | Deland, FL 32720-3236 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2011 |
Last Update Date | 04/06/2020 |