Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | ME136894 | FL |
Y | 208600000X | Surgeon | ME136894 | FL |
N | 2086S0120X | Pediatric Surgery | G87405 | CA |
NPI | 1023100310 |
---|---|
Provider Name | Henri Ronald Ford |
First Address | Miami, FL 33136-1005 |
Second Address | Miami, FL 33136 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 28/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G874050 | (05) | CA |
F51856 | (02) | CA |