Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | ME131947 | FL |
N | 111NI0900X | Internist | ME131947 | FL |
N | 207RH0000X | Hematologist | ME131947 | FL |
Y | 207RX0202X | Medical Oncology | ME131947 | FL |
NPI | 1134548761 |
---|---|
Provider Name | Jess Delaune |
First Address | Gainesville, FL 32610-0278 |
Second Address | Gainesville, FL 32608-1135 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2014 |
Last Update Date | 11/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
020812100 | (05) | FL |