Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | ME 50141 | FL |
NPI | 1033130976 |
---|---|
Provider Name | Moshe Yalon |
First Address | Hallandale Beach, FL 33009-4834 |
Second Address | Hallandale Beach, FL 33009-4834 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2006 |
Last Update Date | 17/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
054701801 | (05) | FL |
07761 | BLUE CROSS BLUE SHEILD (01) | FL |
650160719 | AETNA (01) | FL |
650160719 | CIGNA (01) | FL |
650160719 | UNITED (01) | FL |
E21416 | (02) | FL |