Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | ME89739 | FL |
N | 207RH0003X | Hematology & Oncology | ME89739 | FL |
Y | 207RX0202X | Medical Oncology | ME89739 | FL |
NPI | 1417031238 |
---|---|
Provider Name | Dr. Laura C. Dickerson |
First Address | Fort Myers, FL 33916-2216 |
Second Address | Gainesville, FL 32605-4308 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 08/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
279426800 | (05) | FL |