Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | ME113952 | FL |
NPI | 1063621159 |
---|---|
Provider Name | Hilliary White |
First Address | Pensacola, FL 32501-6339 |
Second Address | Pensacola, FL 32501-6339 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2007 |
Last Update Date | 28/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
006346900 | (05) | FL |
14MH1 | BCBSFL (01) | FL |