Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | PO4178 | FL |
NPI | 1043743800 |
---|---|
Provider Name | Michael Birau |
First Address | Tampa, FL 33617 |
Second Address | Tampa, FL 33612-4745 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2017 |
Last Update Date | 17/07/2020 |