Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | ME0066693 | FL |
NPI | 1255397295 |
---|---|
Provider Name | Mr. Oscar Alejandro Alea |
First Address | Fort Myers, FL 33907-5634 |
Second Address | Fort Myers, FL 33907-5634 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2006 |
Last Update Date | 10/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
376724800 | (05) | FL |
F29274 | (02) |