Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | ME36816 | FL |
NPI | 1215046073 |
---|---|
Provider Name | Dr. Lynda Pollack |
First Address | Orlando, FL 32806-1141 |
Second Address | Orlando, FL 32806-1141 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 29/06/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
065823500 | (05) | FL |