Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 18107 | PR |
NPI | 1043513930 |
---|---|
Provider Name | Dr. Louidor Alliance |
First Address | Fort Pierce, FL 34950-4829 |
Second Address | West Palm Beach, FL 33413-1052 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2010 |
Last Update Date | 28/09/2016 |