Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | ME52984 | FL |
NPI | 1184689051 |
---|---|
Provider Name | Gaetano Ciancio |
First Address | Miami, FL 33136-1124 |
Second Address | Miami, FL 33136-1124 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2006 |
Last Update Date | 12/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3776093-00 | (05) | FL |
G07279 | (02) | FL |