Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | PO2842 | FL |
Y | 222Z00000X | Podiatrist | PO2842 | FL |
NPI | 1023013679 |
---|---|
Provider Name | Dr. Pamela S Dolber |
First Address | Sebring, FL 33872-1917 |
Second Address | Lake Placid, FL 33852-1806 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2005 |
Last Update Date | 02/11/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
340365300 | (05) | FL |
59354208 | (05) | CO |
U86341 | (02) | FL |