Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | ME 110425 | FL |
N | 111NI0900X | Internist | ME 110425 | FL |
Y | 207RX0202X | Medical Oncology | 35.129365 | OH |
N | 207RX0202X | Medical Oncology | ME110425 | FL |
NPI | 1053564542 |
---|---|
Provider Name | Gabriel Ricardo Tinoco Suarez |
First Address | Columbus, OH 43202-1559 |
Second Address | Columbus, OH 43210 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2008 |
Last Update Date | 07/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0192644 | (05) | OH |