Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 4301500237 | MI |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 4301500237 | MI |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 4301500237 | MI |
NPI | 1528413978 |
---|---|
Provider Name | Mr. Leonardo Muntada Cavinatto |
First Address | Beverly Hills, MI 48025-3127 |
Second Address | Beverly Hills, MI 48025-3127 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2016 |
Last Update Date | 22/09/2021 |