Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | ME14669 | FL |
NPI | 1083639165 |
---|---|
Provider Name | Dr. Robert Pickard |
First Address | South Miami, FL 33143-4716 |
Second Address | South Miami, FL 33143-4716 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 07/05/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
042394 | NHP (01) | FL |
042935000 | (05) | FL |
238197 | AVMED (01) | FL |
D67401 | (02) | FL |