Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | PO2135 | FL |
Y | 222Z00000X | Podiatrist | PO2135 | FL |
NPI | 1013904531 |
---|---|
Provider Name | Dr. Ronald Oberman |
First Address | Deerfield Beach, FL 33442-1401 |
Second Address | Deerfield Beach, FL 33442-1401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2005 |
Last Update Date | 09/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U32559 | (02) | FL |