Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT20620 | FL |
NPI | 1003073271 |
---|---|
Provider Name | Mr. Armistice Pedroza Dumon |
First Address | Spring Hill, FL 34606-1966 |
Second Address | Spring Hill, FL 34606-1966 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2008 |
Last Update Date | 16/05/2008 |