Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | CH 11378 | FL |
NPI | 1316345978 |
---|---|
Provider Name | Matthew Sweeney |
First Address | Winter Park, FL 32793-4673 |
Second Address | Bunnell, FL 32110-7710 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2014 |
Last Update Date | 17/01/2019 |