Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | ME 49831 | FL |
NPI | 1497737647 |
---|---|
Provider Name | Dr. Nathan Edward Nachlas |
First Address | Boca Raton, FL 33487-2768 |
Second Address | Boca Raton, FL 33487-2768 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2005 |
Last Update Date | 13/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D50571 | (02) | FL |