Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 48138 | FL |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 48138 | FL |
NPI | 1053350199 |
---|---|
Provider Name | Michael L Douso |
First Address | Tallahassee, FL 32308-4489 |
Second Address | Tallahassee, FL 32308-4489 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 24/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
042874400 | (05) | FL |
D53407 | (02) | FL |