Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0011X | Interventional Cardiology | ME128642 | FL |
NPI | 1073744520 |
---|---|
Provider Name | Dr. Shaun Dane Villiers Smithson |
First Address | Miami, FL 33137-9800 |
Second Address | Aventura, FL 33180-1204 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2009 |
Last Update Date | 14/07/2016 |