Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | DN12725 | FL |
NPI | 1023171030 |
---|---|
Provider Name | Dr. Michael David Insoft |
First Address | St Petersburg, FL 33710-8602 |
Second Address | St Petersburg, FL 33710-8602 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2006 |
Last Update Date | 08/07/2007 |