Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | ME0019332 | FL |
NPI | 1063514644 |
---|---|
Provider Name | Norman Henry Wasserman |
First Address | North Miami Beach, FL 33179-2450 |
Second Address | North Miami Beach, FL 33179-2450 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D58162 | (02) | FL |