Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | ME20967 | FL |
NPI | 1215937669 |
---|---|
Provider Name | Hugo Fernan Scavino |
First Address | Saint Petersburg, FL 33710-6216 |
Second Address | Saint Petersburg, FL 33710-6216 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2005 |
Last Update Date | 08/07/2007 |