Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | DN8326 | FL |
Y | 213EG0000X | General Practice | DN8326 | FL |
NPI | 1003154501 |
---|---|
Provider Name | Michael A Drake |
First Address | Naples, FL 34105-5025 |
Second Address | Naples, FL 34105-5025 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2013 |
Last Update Date | 18/01/2013 |