Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | ME148751 | FL |
NPI | 1053767806 |
---|---|
Provider Name | Joshua Adam Earl |
First Address | Orlando, FL 32803-1834 |
Second Address | Orlando, FL 32803-1834 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2016 |
Last Update Date | 15/07/2021 |