Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | ME98397 | FL |
NPI | 1457553398 |
---|---|
Provider Name | Paul C Makhlouf |
First Address | Fort Myers, FL 33916-2216 |
Second Address | Naples, FL 34110-2307 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2007 |
Last Update Date | 02/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02631 | BCBS OF FL (01) | FL |
279965100 | (05) | FL |
ME98397 | MEDICAL LICENSE (01) | FL |