Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | ME112728 | FL |
NPI | 1013150549 |
---|---|
Provider Name | Eric Forsthoefel |
First Address | Tallahassee, FL 32308 |
Second Address | Tallahasse, FL 32308 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2009 |
Last Update Date | 17/09/2013 |