Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | PRO258 | FL |
N | 222Z00000X | Podiatrist | PRO258 | FL |
Y | 224P00000X | Prosthetist | PRO258 | FL |
NPI | 1417406067 |
---|---|
Provider Name | Peter Ferris |
First Address | Fort Myers, FL 33907-8801 |
Second Address | Fort Myers, FL 33907-8822 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2016 |
Last Update Date | 23/09/2016 |