Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 230433 | MA |
N | 208600000X | Surgeon | 230433 | MA |
N | 2086S0129X | Vascular Surgeon | 4301095536 | MI |
Y | 2086S0129X | Vascular Surgeon | ME120203 | FL |
NPI | 1164595310 |
---|---|
Provider Name | Miechia A Esco |
First Address | Tampa, FL 33624-1871 |
Second Address | Eau Claire, WI 54701-6122 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2006 |
Last Update Date | 16/08/2021 |