Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | ME116665 | FL |
NPI | 1003083247 |
---|---|
Provider Name | Dr. Milan Matthew Lombardi |
First Address | Fort Myers, FL 33908-5182 |
Second Address | St Petersburg, FL 33713-6800 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2008 |
Last Update Date | 12/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H0969Z | (02) | FL |