Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | ME0064493 | FL |
NPI | 1164437455 |
---|---|
Provider Name | Mary Bridget Hart |
First Address | Orlando, FL 32806-2134 |
Second Address | Orlando, FL 32806-2134 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2006 |
Last Update Date | 21/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
23058 | BCBS (01) | FL |
360003245 | MEDICARE RR (01) | |
373223100 | (05) | FL |
3805400 | UNITED HEALTH CARE (01) | |
F63785 | (02) |