Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | ME98569 | FL |
N | 207YP0228X | Pediatric Otolaryngology | ME98569 | FL |
NPI | 1639288749 |
---|---|
Provider Name | Dr. Mitchell B Austin |
First Address | Venice, FL 34293-1982 |
Second Address | Venice, FL 34293-1982 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 15/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
022414200 | (05) | FL |
F58116 | (02) |