Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | ARNP9340336 | FL |
NPI | 1083125728 |
---|---|
Provider Name | Dr. Tom Long Biddle-Xing |
First Address | Palm Beach Gardens, FL 33410-4306 |
Second Address | Palm Beach Gardens, FL 33410 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2017 |
Last Update Date | 15/06/2018 |