Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 01058390A | IN |
Y | 208200000X | Surgeon | ME114675 | FL |
Y | 208600000X | Surgeon | ME114675 | FL |
NPI | 1720037237 |
---|---|
Provider Name | Rodrigo Martinez De Mello Vianna |
First Address | Miami, FL 33136-1005 |
Second Address | Miami, FL 33136-1005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2006 |
Last Update Date | 31/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200467950A | (05) | IN |
I04142 | (02) | IN |