Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | PO 1398 | FL |
NPI | 1013923853 |
---|---|
Provider Name | Lyle Sklar |
First Address | Boynton Beach, FL 33435-4939 |
Second Address | Boynton Beach, FL 33435-4939 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 10/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
041105100 | (05) | FL |
T88553 | (02) | FL |