Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | ME 41845 | FL |
NPI | 1700094703 |
---|---|
Provider Name | Michael J Foley |
First Address | St Petersburg, FL 33716-2918 |
Second Address | Brandon, FL 33511-7637 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2007 |
Last Update Date | 28/08/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D85552 | (02) | FL |