Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | ME120070 | FL |
NPI | 1174782635 |
---|---|
Provider Name | Eric A Hurtado |
First Address | Weston, FL 33331-3609 |
Second Address | Weston, FL 33331-3609 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2008 |
Last Update Date | 05/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
130782YPA1 | MEDICARE ID (01) | VA |