Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | ME90004 | FL |
NPI | 1255439865 |
---|---|
Provider Name | Patricia A Gilroy |
First Address | Saint Petersburg, FL 33713-6800 |
Second Address | Saint Petersburg, FL 33713-6800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 25/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
269742400 | (05) | FL |
43289Z | MEDICARE ID (01) | FL |
I07985 | (02) | FL |