Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | ME88243 | FL |
N | 2086S0102X | Surgical Critical Care | ME88243 | FL |
N | 2086S0127X | Trauma Surgeon | ME88243 | FL |
NPI | 1255494704 |
---|---|
Provider Name | Mr. Yonas Zegeye |
First Address | West Palm Beach, FL 33409-1979 |
Second Address | West Palm Beach, FL 33409-1979 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2006 |
Last Update Date | 19/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
270499400 | (05) | FL |
B42319 | (02) | FL |