Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 17274 | FL |
Y | 2080P0205X | Pediatric Endocrinologist | ME123217 | FL |
NPI | 1023379252 |
---|---|
Provider Name | Kristin Alexandra Dayton |
First Address | Gainesville, FL 32610-0296 |
Second Address | Gainesville, FL 32610 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2012 |
Last Update Date | 25/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
025106600 | (05) | FL |