Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207T00000X | Neurosurgeon | 46970 | MN |
Y | 207T00000X | Neurosurgeon | ME98127 | FL |
NPI | 1073666095 |
---|---|
Provider Name | John Casimir Drygas |
First Address | St Petersburg, FL 33716-1115 |
Second Address | St Petersburg, FL 33716-1115 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2007 |
Last Update Date | 13/08/2015 |