Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | DN8323 | FL |
NPI | 1194790097 |
---|---|
Provider Name | Dr. Victor R First |
First Address | Winter Springs, FL 32708-5029 |
Second Address | Sanford, FL 32773-5489 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2006 |
Last Update Date | 05/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
077137600 | (05) | FL |