Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | ME93081 | FL |
NPI | 1013938422 |
---|---|
Provider Name | Middey Damian |
First Address | Wellington, FL 33414-6108 |
Second Address | Wellington, FL 33414-6108 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2006 |
Last Update Date | 06/05/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
275246800 | (05) | FL |