Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | ME147498 | FL |
N | 111NI0900X | Internist | ME147498 | FL |
N | 207RH0000X | Hematologist | ME147498 | FL |
Y | 207RX0202X | Medical Oncology | ME147498 | FL |
NPI | 1245551134 |
---|---|
Provider Name | Dr. Tadeu F Ambros |
First Address | Fort Myers, FL 33916-2216 |
Second Address | Cape Coral, FL 33909-6529 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2010 |
Last Update Date | 21/12/2021 |