Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | ME83115 | FL |
N | 207PP0204X | Pediatric Emergency Physician | ME83115 | FL |
NPI | 1538130687 |
---|---|
Provider Name | Dr. Pia Myers-Wolfe |
First Address | Jacksonville, FL 32231-4008 |
Second Address | Jacksonville, FL 32209-6511 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2006 |
Last Update Date | 15/11/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000928727C | (05) | GA |
000928727D | (05) | GA |
2648482-00 | (05) | FL |
H51198 | (02) | FL |