Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | ME88180 | FL |
N | 208600000X | Surgeon | ME88180 | FL |
Y | 2086X0206X | Surgical Oncologist | ME88180 | FL |
NPI | 1134166085 |
---|---|
Provider Name | Pamela Hodul |
First Address | Orlando, FL 32891-7770 |
Second Address | Tampa, FL 33612-9416 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2006 |
Last Update Date | 18/12/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
275229800 | (05) | FL |
53063 | BLUE CROSS BLUE SHIELD (01) | FL |
I54754 | (02) | FL |