Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | ME128168 | FL |
N | 208600000X | Surgeon | ME128168 | FL |
Y | 2086S0122X | Plastic and Reconstructive Surgery | ME128168 | FL |
NPI | 1104027796 |
---|---|
Provider Name | James Leighton Mayo |
First Address | Orlando, FL 32806-2134 |
Second Address | Orlando, FL 32806-2134 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2007 |
Last Update Date | 09/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
017623900 | (05) | FL |
IP486Z | (02) | FL |
ME128168 | MEDICAL LICENSE (01) | FL |