Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | ME 29013 | FL |
NPI | 1023183308 |
---|---|
Provider Name | Humphrey C. Jones |
First Address | Miami, FL 33150-2063 |
Second Address | Miami, FL 33150-2063 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D58607 | (02) | FL |