Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | PT0013700 | FL |
NPI | 1003967357 |
---|---|
Provider Name | Mr. William Eric Fiore |
First Address | Greenacres, FL 33463-5921 |
Second Address | Atlantis, FL 33462-1141 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/01/2007 |
Last Update Date | 07/03/2012 |