Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | ME22472 | FL |
N | 207VG0400X | Gynecologist | ME22472 | FL |
NPI | 1134181068 |
---|---|
Provider Name | Richard L. Myers |
First Address | Tampa, FL 33622-5317 |
Second Address | Jacksonville, FL 32258-5472 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2006 |
Last Update Date | 07/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
064740300 | (05) | FL |
D61773 | (02) | FL |