Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | ME19305 | FL |
NPI | 1003879073 |
---|---|
Provider Name | Dr. Michael P Pacin |
First Address | Miami, FL 33175-3584 |
Second Address | Palmetto Bay, FL 33176-7900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2006 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
054370500 | (05) | FL |
71789Z | MEDICARE (01) | FL |
D58190 | (02) | FL |