Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | ME53287 | FL |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | ME53287 | FL |
NPI | 1861457483 |
---|---|
Provider Name | Dr. Moises A Virelles |
First Address | Wellington, FL 33414-9325 |
Second Address | Wellington, FL 33414-9325 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2006 |
Last Update Date | 18/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
061603600 | (05) | FL |
D21231 | (02) | FL |