Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | 20445 | FL |
NPI | 1053533430 |
---|---|
Provider Name | Joseph M. Zeterberg |
First Address | Fort Myers, FL 33919-2229 |
Second Address | Fort Myers, FL 33908-3600 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D-58362 | (02) | FL |