Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | PO2639 | FL |
N | 222Z00000X | Podiatrist | PO2639 | FL |
Y | 213EP1101X | Primary Podiatric Medicine | PO-2639 | FL |
NPI | 1407071475 |
---|---|
Provider Name | Michael Steven Bess |
First Address | Pembroke Pines, FL 33027-1567 |
Second Address | Pembroke Pines, FL 33027-1567 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2007 |
Last Update Date | 13/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
390365600 | (05) | FL |
U69034 | (02) | FL |