Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | OS11845 | FL |
NPI | 1003160516 |
---|---|
Provider Name | Jerry M Cajina |
First Address | Sunrise, FL 33323-2896 |
Second Address | Atlantis, FL 33462-1149 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2012 |
Last Update Date | 06/11/2012 |