Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | ME41307 | FL |
NPI | 1740244243 |
---|---|
Provider Name | Dr. Mark S Mizel |
First Address | Key Biscayne, FL 33149-2779 |
Second Address | Key Biscayne, FL 33149-2779 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2006 |
Last Update Date | 12/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B73877 | (02) | FL |