Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | ME18197 | FL |
NPI | 1265590319 |
---|---|
Provider Name | Michael R Loss |
First Address | Plantation, FL 33313-6066 |
Second Address | Plantation, FL 33313-6066 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2006 |
Last Update Date | 08/07/2007 |