Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | ME90650 | FL |
N | 207ND0900X | Dermatopathologist | ME90650 | FL |
NPI | 1831160472 |
---|---|
Provider Name | Linwood Darden Bond |
First Address | Lakeland, FL 33805-3065 |
Second Address | Lakeland, FL 33803 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2006 |
Last Update Date | 23/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I39233 | (02) |