Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | ME 46414 | FL |
NPI | 1346242435 |
---|---|
Provider Name | Richard Dillon |
First Address | Tampa, FL 33618-2100 |
Second Address | Tampa, FL 33618-2100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2005 |
Last Update Date | 10/02/2012 |