Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | ME97346 | FL |
NPI | 1003006776 |
---|---|
Provider Name | Eddyme Danger |
First Address | Orlando, FL 32806-1114 |
Second Address | Orlando, FL 32806-1114 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2007 |
Last Update Date | 24/07/2008 |