Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | ME0073734 | FL |
NPI | 1467472282 |
---|---|
Provider Name | Mr. Firas A Hamdan |
First Address | Perry, FL 32347 |
Second Address | Perry, FL 32347 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
42305 | BCBS (01) | FL |
BH3781564 | DEA (01) | FL |
F70830 | (02) |