Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0117X | Orthopaedic Spine Surgeon | D 0062993 | MD |
Y | 207XS0117X | Orthopaedic Spine Surgeon | ME96135 | FL |
NPI | 1164466264 |
---|---|
Provider Name | Dr. Victor Hayes |
First Address | Odessa, FL 33556-3427 |
Second Address | Odessa, FL 33556-3427 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2006 |
Last Update Date | 26/04/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I34479 | (02) |