Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | OS-7455 | FL |
N | 207QG0300X | Family Doctor - Geriatric Medicine | OS-7455 | FL |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | OS-7455 | FL |
NPI | 1073579355 |
---|---|
Provider Name | Marcos Rejtman |
First Address | Miramar, FL 33025-3925 |
Second Address | Hollywood, FL 33021 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2006 |
Last Update Date | 15/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
256876400 | (05) | FL |
G41579 | (02) |