Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | PO2489 | FL |
N | 222Z00000X | Podiatrist | PO2489 | FL |
Y | 213EP1101X | Primary Podiatric Medicine | PO2489 | FL |
NPI | 1487831350 |
---|---|
Provider Name | Dr. Robert E Hole |
First Address | Edgewater, FL 32132-1671 |
Second Address | Edgewater, FL 32132-1671 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2008 |
Last Update Date | 23/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U43010 | (02) | FL |