Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | CH8620 | FL |
NPI | 1609873157 |
---|---|
Provider Name | Dr. Ronald M Repice II |
First Address | Naples, FL 34112-8715 |
Second Address | Naples, FL 34112-8715 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2005 |
Last Update Date | 09/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
89613B | MEDICARE ID NUMBER (01) | FL |
K8856 | MEDICARE GROUP NUMBER (01) | FL |
U48983 | (02) | FL |