Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | OS7863 | FL |
NPI | 1669549374 |
---|---|
Provider Name | Francis Xavier Conidi |
First Address | Port Saint Lucie, FL 34952-5630 |
Second Address | Port Saint Lucie, FL 34952-5630 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2006 |
Last Update Date | 05/04/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G98816 | (02) | FL |