Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0105X | Surgery of the Hand | ME112387 | FL |
NPI | 1548321599 |
---|---|
Provider Name | Justin Calvert Kearse |
First Address | Palm Beach Gardens, FL 33410-4625 |
Second Address | West Palm Beach, FL 33411-3803 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2006 |
Last Update Date | 14/06/2020 |