Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | ME133301 | FL |
Y | 213ES0000X | Sports Medicine | ME133301 | FL |
NPI | 1336403393 |
---|---|
Provider Name | James Presley |
First Address | Pensacola, FL 32522-7567 |
Second Address | Navarre, FL 32566-3614 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2012 |
Last Update Date | 02/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
021997000 | (05) | FL |