Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | DN 9764 | FL |
N | 1223G0001X | General Practice | DE00009957 | WA |
N | 213EG0000X | General Practice | DE00009957 | WA |
NPI | 1710013297 |
---|---|
Provider Name | Marco A Alberts |
First Address | Clearwater, FL 33762-2877 |
Second Address | Clearwater, FL 33762-2877 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2007 |
Last Update Date | 19/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0004418100 | (05) | FL |
5037171 | (05) | WA |