Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | PO01949 | FL |
NPI | 1548223647 |
---|---|
Provider Name | Martin Lenoci |
First Address | Melbourne, FL 32901-5594 |
Second Address | Melbourne, FL 32901-5594 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2006 |
Last Update Date | 18/09/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0884270001 | DME SUPPLIER NUMBER (01) | |
340063800 | (05) | FL |
480013392 | RAIL ROAD MEDICARE (01) | |
T87854 | (02) |