Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | ME83528 | FL |
NPI | 1063484848 |
---|---|
Provider Name | Dr. Sean Tirney |
First Address | Daytona Beach, FL 32118-5026 |
Second Address | Daytona Beach, FL 32118-5026 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2006 |
Last Update Date | 17/05/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
262724800 | (05) | FL |
H15355 | (02) |