Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | ME79538 | FL |
NPI | 1083641054 |
---|---|
Provider Name | Dr. Yong Bao |
First Address | Miami, FL 33101-6960 |
Second Address | Miami, FL 33101-6960 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 29/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2614812-00 | (05) | FL |
H45310 | (02) | FL |