Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | ME53942 | FL |
NPI | 1073555900 |
---|---|
Provider Name | Dr. Robert Leyrer |
First Address | Miami, FL 33143-5165 |
Second Address | Port Charlotte, FL 33952-5000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E21393 | (02) | FL |