Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0105X | Surgery of the Hand | ME0055261 | FL |
NPI | 1013034925 |
---|---|
Provider Name | Dr. Lewis Eastlick |
First Address | Plantation, FL 33317-2813 |
Second Address | Plantation, FL 33317-2813 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2007 |
Last Update Date | 03/10/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F02375 | (02) | FL |