Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | OS10079 | FL |
NPI | 1083683122 |
---|---|
Provider Name | Robert J Pearl |
First Address | Coral Springs, FL 33071-6089 |
Second Address | Coral Springs, FL 33071-6089 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 27/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D41545 | (02) | MO |