Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | ME19375 | FL |
NPI | 1609862077 |
---|---|
Provider Name | Norman Henry Pevsner |
First Address | Dania Beach, FL 33004-1607 |
Second Address | Coconut Creek, FL 33073-3414 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2005 |
Last Update Date | 08/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D26951 | (02) | FL |