Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | OS14686 | FL |
N | 111NI0900X | Internist | OS14686 | FL |
N | 207RH0000X | Hematologist | OS14686 | FL |
Y | 207RX0202X | Medical Oncology | OS14686 | FL |
NPI | 1326484536 |
---|---|
Provider Name | Kristen Michelle Gonter-Aubin |
First Address | Fort Myers, FL 33916-2216 |
Second Address | Englewood, FL 34223-3992 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2013 |
Last Update Date | 10/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
106479800 | (05) | FL |