Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | OS3562 | FL |
Y | 208D00000X | General Practice Physician | OS3562 | FL |
NPI | 1033177662 |
---|---|
Provider Name | Sanford M Epstein |
First Address | Gulf Breeze, FL 32561-4470 |
Second Address | Gulf Breeze, FL 32561 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 05/08/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D84665 | (02) |