Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | ME0051923 | FL |
NPI | 1003912759 |
---|---|
Provider Name | Kenneth Aung-Din |
First Address | Orlando, FL 32886-0554 |
Second Address | Jacksonville, FL 32216-4207 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00777807A | (05) | GA |
10718 | BCBS (01) | FL |
E66569 | (02) | FL |