Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 37857 | AL |
NPI | 1003255993 |
---|---|
Provider Name | Jose Nahun Galeas Soriano |
First Address | Mobile, AL 36604-1402 |
Second Address | Mobile, AL 36604-1416 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2013 |
Last Update Date | 09/07/2019 |