Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | ME39894 | FL |
NPI | 1063433555 |
---|---|
Provider Name | Edward J Scheel |
First Address | Port St Lucie, FL 34952-7553 |
Second Address | Port St Lucie, FL 34952-7553 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2006 |
Last Update Date | 30/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
066510000 | (05) | FL |
D56771 | (02) | FL |