Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | ME0055830 | FL |
N | 111NI0900X | Internist | ME0055830 | FL |
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | ME0055830 | FL |
NPI | 1053365551 |
---|---|
Provider Name | Marcelo Vianna Bendix |
First Address | Miami, FL 33143-5724 |
Second Address | Miami, FL 33175-8103 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 02/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
377187300 | (05) | FL |
E60451 | (02) | FL |
ME0055830 | MEDICAL LICENSE (01) | FL |